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!style="width: 300px;background:#4479BA"|{{fontcolor|#FFF| SYSTOLIC MURMUR}} !!style="width: 300px;background:#4479BA"|{{fontcolor|#FFF|  DIASTOLIC MURMUR}} !! style="width: 300px;background:#4479BA"|{{fontcolor|#FFF| Continuous Murmur}}  
!style="width: 300px;background:#4479BA"|{{fontcolor|#FFF| SYSTOLIC MURMUR}} !!style="width: 300px;background:#4479BA"|{{fontcolor|#FFF|  DIASTOLIC MURMUR}} !! style="width: 300px;background:#4479BA"|{{fontcolor|#FFF| Continuous Murmur}}  
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| ❑ '''[[MR resident survival guide#Treatment|STEMI / LBBB]]''' <br> ❑ '''[[NSTEMI resident survival guide#Treatment|NSTEMI / Unstable angina]]''' <br> ❑ '''[[Chronic stable angina treatment|Stable angina]]'''<br> ❑ '''[[Pericarditis resident survival guide#Treatment|Pericarditis]]'''<br> ❑ '''[[Aortic dissection resident survival guide#Treatment|Aortic dissection]]'''<br> ❑ '''[[Aortic stenosis resident survival guide#Treatment|Aortic stenosis]]'''  <br>❑ '''[[Prinzmetal's angina#Medical Therapy|Prinzmetal's angina]]''' <br> ❑  '''[[PCI complications: coronary vasospasm#Treatment|PCI-induced coronary vasospasm]]''' <br> ❑ '''[[New guidelines for the management of cocaine chest pain|Cocaine induced coronary vasospasm]]'''
| ❑ '''[[MR resident survival guide#Treatment]]''' <br> ❑ '''[[NSTEMI resident survival guide#Treatment|NSTEMI / Unstable angina]]''' <br> ❑ '''[[Chronic stable angina treatment|Stable angina]]'''<br> ❑ '''[[Pericarditis resident survival guide#Treatment|Pericarditis]]'''<br> ❑ '''[[Aortic dissection resident survival guide#Treatment|Aortic dissection]]'''<br> ❑ '''[[Aortic stenosis resident survival guide#Treatment|Aortic stenosis]]'''  <br>❑ '''[[Prinzmetal's angina#Medical Therapy|Prinzmetal's angina]]''' <br> ❑  '''[[PCI complications: coronary vasospasm#Treatment|PCI-induced coronary vasospasm]]''' <br> ❑ '''[[New guidelines for the management of cocaine chest pain|Cocaine induced coronary vasospasm]]'''
| ❑ '''[[Pulmonary embolism resident survival guide#Treatment|Pulmonary embolism]]'''<br> ❑ '''[[Tension pneumothorax resident survival guide#Treatment|Pneumothorax]]'''<br>❑ '''[[Asthma exacerbation resident survival guide|Asthma exacerbation ]]'''<br> ❑ '''[[Pulmonary hypertension resident survival guide#Treatment|Pulmonary hypertension]]'''<br> ❑ '''[[Pneumonia medical therapy |Pneumonia ]]''' <br> ❑ '''[[Pleurisy medical therapy |Pleuritis]]'''
| ❑ '''[[Pulmonary embolism resident survival guide#Treatment|Pulmonary embolism]]'''<br> ❑ '''[[Tension pneumothorax resident survival guide#Treatment|Pneumothorax]]'''<br>❑ '''[[Asthma exacerbation resident survival guide|Asthma exacerbation ]]'''<br> ❑ '''[[Pulmonary hypertension resident survival guide#Treatment|Pulmonary hypertension]]'''<br> ❑ '''[[Pneumonia medical therapy |Pneumonia ]]''' <br> ❑ '''[[Pleurisy medical therapy |Pleuritis]]'''
| ❑ '''[[Pancreatitis medical therapy |Pancreatitis ]]''' <br> ❑ '''[[Acute cholecystitis resident survival guide#Treatment Approach|Acute cholecystitis]]''' <br> ❑ '''[[Gastroesophageal reflux disease medical therapy|GERD]]''' <br>❑ '''[[Peptic ulcer medical therapy|Peptic ulcer]]''' <br>❑ '''[[Nutcracker esophagus medical therapy|Esophageal spasm]]'''<br>❑ '''[[Mallory-Weiss syndrome medical therapy|Mallory-Weiss syndrome]]''' <br>
| ❑ '''[[Pancreatitis medical therapy |Pancreatitis ]]''' <br> ❑ '''[[Acute cholecystitis resident survival guide#Treatment Approach|Acute cholecystitis]]''' <br> ❑ '''[[Gastroesophageal reflux disease medical therapy|GERD]]''' <br>❑ '''[[Peptic ulcer medical therapy|Peptic ulcer]]''' <br>❑ '''[[Nutcracker esophagus medical therapy|Esophageal spasm]]'''<br>❑ '''[[Mallory-Weiss syndrome medical therapy|Mallory-Weiss syndrome]]''' <br>

Revision as of 18:08, 16 August 2020



    • Holosystolic (pansystolic) murmurs:
      • chronic MR.
      • chronic TR.
      • VSD
      • PDA with pulmonary hypertension
    • Midsystolic (systolic ejection) murmurs
      • Innocent murmur (still's murmur)
      • AS
      • PS
      • HOCM
      • Functional:
        • ASD
        • VSD
        • Straight back syndrome
        • Aortic root dilation
        • Pulmonary artery dilation
        • pulmonary hypertension
        • Hyper-kinetic status:
          • pregnancy
          • Anemia
          • hyperthyroidism
          • exercise
          • A-V fistula
    • Early systolic murmurs
      • Acute MR
      • Acute TR
      • Small VSD
    • Mid to late systolic murmurs
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Maximum intensity over apex Radiation to axilla or base A2 not heard over apex Decreased intensity with amyl nitrate
 
 
Maximum intensity over left sternal border Radiation to epigastrium and right sternal border Increased intensity during inspiration Prominent c-v wave with sharp y descent in jugular venous pulse
 
 
Maximum intensity over lower left third and fourth interspace Widespread radiation, palpable thrill Decreased intensity with amyl nitrate No change in intensity during inspiration Wide splitting of S2
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Mitral regurgitation
 
 
Tricuspid regurgitation
 
 
Favors ventricular septal defect; often difficult to differentiate from mitral regurgitant murmur
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Hyperdynamic left ventricular impulse
Wide splitting of S2
 
Sustained left ventricular impulse
Single S2 or narrow splitting of S2
 
 
 
Prominent left parasternal diastolic impulse
Normal brief left parasternal systolic impulse
Normal P2, Rarely paradoxical S2
 
Primary
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Sustained systolic left parasternal impulse Narrow splitting of S2 with marked increase in intensity of P2
 
Secondary to pulmonary hypertension
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Primary mitral regurgitation
 
Secondary mitral regurgitation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 





SYSTOLIC MURMUR DIASTOLIC MURMUR Continuous Murmur
MR resident survival guide#Treatment
NSTEMI / Unstable angina
Stable angina
Pericarditis
Aortic dissection
Aortic stenosis
Prinzmetal's angina
PCI-induced coronary vasospasm
Cocaine induced coronary vasospasm
Pulmonary embolism
Pneumothorax
Asthma exacerbation
Pulmonary hypertension
Pneumonia
Pleuritis
Pancreatitis
Acute cholecystitis
GERD
Peptic ulcer
Esophageal spasm
Mallory-Weiss syndrome
❑ Musculoskeletal pain:
Costochondritis
Rheumatoid arthritis
Rib fracture

Herpes zoster
Anxiety
Panic disorder