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Systolic murmurs
Sound and timing:
Cause:
Holosystolic or
pansystolic
murmurs
Usually a gentle blowing sound
throughout systole that does not vary
much in intensity.
Blood flowing through a structure that is

usually closed during systole, such as

regurgitation across the mitral or tricuspid

valve or blood flowing through a septal
defect.
Mid-systolic
ejection
murmurs
Usually a harsh crescendodecrescendo murmur. It starts quietly at
the beginning of systole but gradually
gets louder, rising to a crescendo in
mid-systole before gradually quietening
down again (decrescendo) by the end
of systole.
Blood being forced through a valve that
is open during systole as is normal, but
has narrowed.
Usually a crescendo sound that starts
quietly in mid to late systole and
gradually gets louder.
A valve that functions normally at the
start of systole but begins to leak halfway
through systole.
Late systolic
murmurs
Most common diagnoses:
Mitral valve incompetence
Tricuspid valve incompetence
Ventricular septal defect

Aortic stenosis

Aortic sclerosis

Pulmonic stenosis

A flow murmur – indicates
increased blood flow or blood
flow is faster than normal.

Mitral valve prolapse
Note:

Short, quiet systolic murmurs are often benign, but long systolic murmurs usually indicate disease or defect.

Systolic flow murmurs are often benign in children and pregnant women but may indicate, for example, fever, anaemia or hyperthyroidism.

Some sounds that do not originate in the heart, such as subclavian and carotid murmurs, may resemble systolic murmurs.