The Sounds
Descriptions
Information on Heart Murmurs – Click for full size
Eponymous signs of aortic regurgitation
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Name
|
Sign
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Austin Flint Murmur
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Mid-diastolic murmur in the absence of mitral stenosis
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Becker Sign
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Accentuated Retinal Artery Pulsation
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Corrigan’s Sign
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Collapsing pulse (aka ‘Water Hammer pulse’)
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De Musset sign
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Head bobbing in time with the heart beat
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Duroziez sign
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Femoral artery sounds under compression
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Gerhard Sign
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Pulsatile spleen
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Hill Sign
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Higher systolic BP in the legs than in the arms
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Mayne Sign
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Drop in systolic BP >15mmHg when arm is raised
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Mueller sign
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Pulsatile uvula
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Quincke sign
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Exaggerated nail bed pulsations
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Rosenback sign
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Pulsatile liver
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Traube Sign
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Loud sounds heard in systole and diastole over the femoral artery. Sometimes described as a pistol shot – heard with light compression
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Grading Murmurs
If you hear a murmur you should be able to describe:
- Systolic or Pansystolic
- Duration – e.g. pan-systolic, ejection systolic
- Site best heard at – e.g. Mitral area
- Radiation – e.g. axilla
- Grade
Murmurs can be graded on a scale of 1 – 6:
|
Grade
|
Description
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Thrill
|
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1
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Very faint, can only be heard with stethoscope under optimal conditions
|
No
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2
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Only heard with stethoscope, but easily audible
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No
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3
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Still only heard through the stethoscope, but loud
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No
|
|
4
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Similar to Grade 3, but also palpable
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YES
|
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5
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Louder than grade 4, and palpable thrill
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YES
|
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6
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Audible without the use of a stethoscope, and palpable thrill
|
YES
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Whats the difference between a thrill and a heave?
- A thrill – is a palpable murmur
- A heave – is the result of LVH (Left ventricular hypertrophy) and feels like something pushing your hand off the chest