What Is a Systolic Heart Murmur?

Systolic murmur (systolic murmur) is the most common clinical murmur. It can be functional or organic. When the mitral regurgitation is insufficiency, during the left ventricular systole, blood flows back from the left ventricle to the left atrium and produces systolic murmurs, which are transmitted to the left axilla. Anything that can increase the pressure difference between the left ventricle and the left atrium of the systole can increase the noise. Asymptomatic or mild symptoms do not require treatment and follow-up regularly. Organic systolic murmur should be treated for the primary disease.

Basic Information

English name

Systolic Murmurs

Visiting department

Cardiology

Common locations

heart

Common causes

Organic properties include rheumatic mitral regurgitation, mitral valve prolapse, papillary muscle dysfunction, aortic stenosis, congenital pulmonary stenosis, etc.

Common symptoms

When the mitral valve is incomplete, the left ventricular systolic blood flows back from the left ventricle to the left atrium, resulting in systolic murmurs, which are transmitted to the left axilla

Causes of systolic murmur and common diseases

1. Apical Functionality is commonly found in fever, anemia, hyperthyroidism, pregnancy, and strenuous exercise. It is also found in some healthy people when they are quiet. The auscultation is characterized by a hair-like type, soft in nature, short and weak (grade 1/6 or 2/6), mostly in the middle contraction, limited, not transmitted to other places, and may disappear after exercise or after removing the cause. Relativity is caused by left ventricular enlargement and relative mitral insufficiency. It is found in dilated cardiomyopathy and hypertensive heart disease. Auscultation is characterized by a murmur that is soft and soft, and the murmur can be reduced after the left ventricular cavity is reduced. Organic is more common, mainly seen in mitral regurgitation of rheumatic heart valve disease, mitral valve prolapse, and papillary muscle dysfunction. Auscultation is characterized by total systolic hair-like noise, which can cover the first heart sound. It is rough and high-profile. The intensity is usually 3/6 or above. It is transmitted to the left underarm or left scapular region. Strengthen, the left side is more obvious. Noise from other parts of the anterior region of the heart can also be transmitted to the apex, such as systolic murmur of tricuspid insufficiency.

2. Aortic valve area The organic nature is mainly found in aortic valve stenosis. Auscultation is characterized by jet-like or hair-like murmurs that are rhombus-shaped and do not cover the first heart sound. They are rough in nature, often accompanied by tremors, and murmurs are transmitted to the neck, with A2 weakening. Relativity is mainly found in aortic atherosclerosis, aortic dilatation, and hypertension. Auscultation is characterized by softer hair-like noise, often accompanied by A2 hyperactivity.

3. Pulmonary valve area is more harmless . Most commonly seen in healthy children and adolescents, auscultation is characterized by soft and weak, low-pitched hair-like murmurs, non-conducting, often below grade 2/6, apparent when lying, and weakening or disappearing when sitting. Organicness is rare and can be seen in congenital pulmonary stenosis. The noise is jet-like, rough and loud, with a strength of 3/6 or above, and is diamond-shaped. It is transmitted to the surroundings and back, with tremor, and P2 weakens and splits.

4. The tricuspid valve area is relatively common. Due to the expansion of the right ventricular cavity, the tricuspid valve is relatively closed. The characteristics of auscultation are hair-like, softer, enhanced during inhalation, weakened at the end of expiration, and can be conducted to the apical area. Care must be taken to distinguish it from mitral insufficiency. Organic nature is rare, and the noise characteristics are similar to mitral insufficiency.

5. Other parts

In ventricular septal defects, rough and loud systolic murmurs can be heard in the third and fourth intercostal spaces on the left margin of the sternum. Loudness is often above grade 3/6, and can be transmitted to other parts of the anterior heart region with tremor.

Systolic noise

Combined with clinical signs and symptoms, cardiac auscultation was performed.

Differential diagnosis of systolic murmur

Apical systolic murmur

Rheumatic mitral valve inflammation, rheumatic mitral valve insufficiency, infective endocarditis, rheumatic heart disease, systemic lupus erythematosus, scleroderma papillary muscle insufficiency or broken cord, (coronary heart disease, myocardial infarction ) Idiopathic abdominal rupture, dilated cardiomyopathy, open arterial ducts with atrial septal defect, hyperthyroidism heart disease during pregnancy, anemia heart disease, athlete's heart disease athlete heart syndrome, high altitude heart disease, third degree Atrioventricular block, carcinoid syndrome. Left heart failure aortic valve regurgitation, relative mitral valve regurgitation.

2. Aortic valve systolic murmur

Rheumatic aortic valve inflammation Rheumatic aortic valve stenosis. Aortic atherosclerosis, hypertensive heart disease supra-aortic stenosis syndrome, congenital two-leaf aortic valve, aortic constriction, syphilitic aorticitis, aortic aneurysm, Ebstein malformation severe aortic valve insufficiency, Complete atrioventricular block. Hyperthyroid heart disease, anemia heart disease, carotid murmur and other causes of aortic valve systolic murmur.

3. The third and fourth intercostal systolic murmurs on the left margin of the sternum

Ventricular septal defect Infants with non-pathological systolic murmurs, pulmonary valve stenosis or funnel stenosis, mitral valve insufficiency, aortic valve stenosis, aortic constriction, atrial septal defect, obstructive primary cardiomyopathy, tricuspid Valve insufficiency, arterial duct is not closed, and so on.

4. Pulmonary valve systolic murmur

Rheumatic pulmonary valvulitis, rheumatic pulmonary stenosis, infective endometritis, congenital pulmonary artery stenosis, pulmonary artery and branch stenosis, Fallot tetralogy, idiopathic pulmonary artery dilatation, primary pulmonary hypertension, rheumatism Mitral valve stenosis, chronic pulmonary heart disease, high altitude heart disease, atrial septal defect of straight back syndrome, hyperthyroid heart disease during pregnancy, anemia heart disease, beriberi heart disease, etc.

5. Tricuspid systolic murmur

Rheumatic tricuspiditis Rheumatic tricuspid valve insufficiency. Infective endocarditis, papillary muscle insufficiency, valve relaxation. Electrical high radiation injury, rheumatic heart disease with mitral valve disease combined with pulmonary hypertension caused a significant enlargement of the right ventricle, a large number of left-right shunts of congenital heart disease (drainage of pulmonary vein malformations with atrial septal defect), and primary pulmonary hypertension.

6.Continuous murmur at the bottom of the heart

Arterial duct is not closed, aortic pulmonary artery septal defect, pulmonary arteriovenous aneurysm, aortic sinus aneurysm breaks into right ventricle (atrial), congenital coronary arteriovenous aneurysm, complete pulmonary vein malformation drainage tricuspid valve atresia, intrathoracic anastomosis Postoperative ventricular septal defect with aortic valve insufficiency, mitral valve insufficiency with aortic valve insufficiency, and aortic valve insufficiency with stenosis.

Systolic murmur treatment principles

Asymptomatic or mild symptoms, without treatment, normal work and life, regular follow-up. Organic systolic murmur should be treated for the primary disease.