Innocent heart murmurs in adults
EBM Guidelines
Jul 3, 2021 • Latest change Jan 24, 2022
Table of contents
Extract
- Innocent murmurs include
- murmurs of physiological origin
- occasionally murmurs originating from haemodynamically insignificant cardiac defects.
- Innocent murmurs caused by accelerated blood flow are common in young adults.
- Fever, anaemia, tachycardia and a thin or flat chest wall may intensify flow sounds making them resemble a murmur of a valvular disease.
- Innocent nature of the murmur is suggested by the following features:
- short early systolic or mid-systolic murmur, grade 1–2
- point of maximum intensity beside the sternum on the left and attenuates in a recumbent position
- systolic ejection murmur in the pulmonary valve auscultation area
- normal S2 (not constantly split)
- no other abnormalities on auscultation
- good performance status, normal ECG and chest x-ray.
- A murmur must not be considered innocent until the patient has undergone thorough
investigation.
- If necessary, an echocardiography Echocardiography as an outpatient procedure2 should be carried out to confirm diagnosis.
- Diastolic murmurs always originate from an organic abnormality which may, nevertheless, be haemodynamically insignificant.
Search terms
Aorta, Aortic Valve, Brachiocephalic Trunk, Heart Auscultation, Heart Murmurs, Heart Sounds, Pulmonary Valve, R01.0, R01.1, Stll´s murmur, aortic ejection sound, diastolic murmur, ejection murmur, innocent heart murmur, physiological murmur, pulmonary ejection sound, turbulence, venous hum