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innocent murmur
Etiology:
- mammary souffle
- cervical venous hum
- heart murmurs of pregnancy
- result from increased intravascular volume
- fever
- anemia
- hyperthyroidism
- Still murmur
Clinical manifestations:
- patient is asymptomatic
- typically midsystolic, located at base of heart, grade 1-3/6 without radiation
- normal splitting of S2, normal intensity of A2
- soft S3 may be present [3]
- audible along the right upper sternal border [3]
- heart murmurs of pregnancy
a) may mimic valvular heart disease
b) increased P2, S3
c) early peaking systolic murmur over the left sternal border
d) S4 >= 3/6 in intensity & fixed S2 are signs of serious cardiac disease
Special laboratory:
- transthoracic echocardiogram not needed
- murmur should not be of sufficient intensity
Specific
cervical venous hum
mammary souffle
Still murmur
General
systolic murmur
References
- Harrison's Principles of Internal Medicine, 13th ed.
Companion Handbook, Isselbacher et al (eds), McGraw-Hill
Inc. NY, 1995, pg 327-28
- Harrison's Principles of Internal Medicine, 14th ed.
Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 199
- Medical Knowledge Self Assessment Program (MKSAP) 14, 16, 17
American College of Physicians, Philadelphia 2006, 2012, 2015
- What Is a Heart Murmur?
http://www.nhlbi.nih.gov/health/dci/Diseases/heartmurmur/hmurmur_what.html