Murmur
Formal Definition
An abnormal heart sound produced by turbulent blood flow through or near the heart, classified by timing (systolic/diastolic), intensity (Grades 1–6), quality (harsh, blowing, rumbling), location, and radiation.
How It's Used on the Ward
"Heard a murmur" or "has a known murmur" — warrants description and often cardiology input if new or changed.
Example
""New Grade 3/6 systolic murmur loudest at the right upper sternal border with radiation to the carotids — given the picture, worried about aortic stenosis. Ordered echo, cardiology aware.""
Clinical Context
Grading: 1 = barely audible, 3 = easily heard without thrill, 5 = heard with stethoscope barely on chest, 6 = heard without stethoscope. Louder is not always more serious. Timing matters: holosystolic murmur at apex = MR; harsh systolic at right base = AS; diastolic rumble at apex = MS. A new murmur in the setting of fever + bacteremia = endocarditis until proven otherwise.