Understanding Systolic Murmurs and Their Key Features

Overview of Heart Murmurs

  • Heart murmurs are sounds produced by turbulent blood flow within the heart.

Systolic Murmurs

  • Systolic murmurs occur during the contraction phase of the heart cycle (systole).
  • Focus on identifying features of these murmurs using the mnemonic LISP T.

Features of Murmurs (LISP T)

  1. Location

    • Identify where the murmur originated: which heart valve area or part of the chest.

  2. Intensity (Grade)

    • Rated from 1 to 6:
      • 1/6: Very subtle; requires a quiet room and precise placement of the stethoscope to detect.
      • 2/6: More typical; easily detectable by an average medical student.
      • 3/6: Moderately loud murmur.
      • 4/6: Loud murmur.
      • 5/6: Can be heard with just the edge of the stethoscope.
      • 6/6: Audible even when the stethoscope is hovering above the chest.

  3. Shape

    • Describes the contour of the murmur:
      • Ascending, descending, or constant amplitude during systole (hollow systolic).

  4. Pitch

    • Refers to the frequency of the sound:
      • Higher pitch sounds vs. lower pitch sounds.

  5. Timing

    • Determines when the murmur occurs:
      • During systole or diastole and its specific timing (early, mid, late systole/diastole).

Murmurs to Review

  • Five Systolic Murmurs: Key murmurs encountered during examinations and clinical practice.
  • Two Diastolic Murmurs: Recognize these as less frequent but significant sounds.

Conclusion

  • Understanding these features helps differentiate types of murmurs and determine their clinical significance. Focus on the LISP T acronym as a guide while auscultating and analyzing heart murmurs.