murmurs

Q: Which of the following is NOT considered a heart murmur configuration? (select one)

A) Harsh

B) Plateau 

C) Crescendo 

D) Decrescendo

E) Crescendo-decrescendo

Answer: A

The objective of this question is to make aware of the distinction between configurations, pitch, and intensity of heart murmurs.

Configurations are considered the description of the time course of the murmur. The four major configurations of heart murmurs are:

• Crescendo (increasing)
• Decrescendo (diminishing)
• Crescendo-decrescendo (increasing-decreasing)
• Plateau (unchanged in intensity)

Harsh, rumbling, scratchy, grunting, blowing, squeaky, vibratory, and musical is considered the pitch of the murmurs - can be described as a qualitative description.

The intensity of the murmur runs from Grades 1 to 6, depending on the faintness to the loudness of the murmur.

#cardiology

#physical-exam

References:

1. Ferasin L, Ferasin H, Cala A, Creelman N. Prevalence and Clinical Significance of Heart Murmurs Detected on Cardiac Auscultation in 856 Cats. Vet Sci. 2022 Oct 13;9(10):564. doi: 10.3390/vetsci9100564. PMID: 36288177; PMCID: PMC9611806.

2. Alpert MA. Systolic Murmurs. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 26. Available from: https://www.ncbi.nlm.nih.gov/books/NBK345/

3. Kumar D, Carvalho P, Antunes M, Paiva RP, Henriques J. Heart murmur classification with feature selection. Annu Int Conf IEEE Eng Med Biol Soc. 2010;2010:4566-9. doi: 10.1109/IEMBS.2010.5625940. PMID: 21095796.