Heart Murmurs

leart murmurs are distinguishable from heart sounds by their longer dura-ion. They are attributed to turbulent blood flow and may be "innocent," is with flow murmurs of young adults, or diagnostic of valvular heart disease. A stenotic valve has an abnormally narrowed valvular orifice that ob-tructs blood flow, as in aortic stenosis, and causes a characteristic murmur. o does a valve that fails to fully close, as in aortic regurgitation or insuffi-

ciency. Such a valve allows blood to leak backward in a retrograde direction and produces a regurgitant murmur.

To identify murmurs accurately, you must learn to assess the chest wall location where they are best heard, their timing in systole or diastole, and their qualities. In the section on Techniques of Examination, you will learn to integrate several characteristics, including murmur intensity, pitch, duration, and direction of radiation (see pp. __-__).

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