Heart murmurs are distinct heart sounds distinguished by their pitch and their longer duration. They are attributed to turbulent blood flow and are usually diagnostic of valvular heart disease. At times, they may also represent "innocent" flow murmurs, especially in young adults. A stenotic valve has an abnormally narrowed valvular orifice that obstructs blood flow, as in aortic stenosis, and causes a characteristic murmur. So does a valve that fails to fully close, as in aortic regurgitation. Such a valve allows blood to leak backward in a retrograde direction and produces a regurgitant murmur.

To identify murmurs accurately, you must learn where they are best heard on the chest wall, their timing in systole or diastole, and their descriptive qualities. In the Techniques of Examination section, you will learn to integrate location and timing with the murmur's shape, maximal intensity, direction of radiation, grade of intensity, pitch, and quality.

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