Systolic Murmurs
1) Quiz Link
Steven Mcgee described 6 murmur patterns, after the seemingly painstaking process of examining 376 patients with systolic murmurs and correlating findings to echocardiography [1]. These patterns are:
- Broad apical-base
- Small apical base
- Lower left sternal
- Broad apical
- Isolated apical
- Isolated base
Aortic stenosis best correlated with the apical-base patterns (broad > small) with a LR 9.7. Mitral regurgitation correlated with a broad apical pattern, LR 6.8, and less so an isolated apical pattern. Finally, tricuspid stenosis most often had a left lower sternal pattern, LR 8.4. These patterns especially held true as the severity of the pathology increased.
See his Figure 2 for more details.
- McGee S. Etiology and diagnosis of systolic murmurs in adults. Am J Med. 2010 Oct;123(10):913-921.e1.
