GITNUXREPORT 2026

Heart Murmur Statistics

Heart murmurs are common and often harmless sounds that vary by age.

Min-ji Park

Research Analyst focused on sustainability and consumer trends.

First published: Feb 13, 2026

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Statistic 1

Heart murmurs are first-line detected by auscultation with phonocardiography sensitivity 70-90% for grade 3+

Statistic 2

Echocardiography confirms pathology in 85% of referred pediatric murmurs, specificity 92%

Statistic 3

Handheld ultrasound detects murmurs needing echo with 97% sensitivity vs stethoscope alone 80%

Statistic 4

Grade of murmur (1-6 Levine scale) correlates with pathology risk: grade 1-2 <5%, grade 4+ >50%

Statistic 5

ECG shows LVH in 40% of pathologic murmurs from volume overload like MR/AR

Statistic 6

Chest X-ray reveals cardiomegaly in 60% of significant CHDs with murmurs

Statistic 7

Doppler echo gradients precisely quantify stenosis severity: mild <25 mmHg, severe >64 mmHg aortic

Statistic 8

Phonocardiogram timing distinguishes systolic (S1-S2) vs diastolic (S2-S1) murmurs with 95% accuracy

Statistic 9

Pulse oximetry screening detects critical CHD murmurs indirectly in 0.25% newborns failing >95% SpO2

Statistic 10

MRI quantifies shunt ratios in ASD/VSD murmurs with Qp/Qs >1.5 indicating significance

Statistic 11

Holter monitoring captures dynamic murmurs in HCM varying with posture/activity in 80% cases

Statistic 12

BNP levels >100 pg/mL raise suspicion for pathologic murmur in dyspneic patients 75% specificity

Statistic 13

Transesophageal echo visualizes posterior structures for MR murmurs with 98% resolution vs transthoracic 85%

Statistic 14

Exercise stress echo provokes latent HCM murmurs with gradient >30 mmHg post-exercise diagnostic

Statistic 15

Cardiac catheterization measures direct gradients in discrepant murmurs, gold standard for equivocal cases

Statistic 16

AI stethoscope algorithms classify murmurs with 92% accuracy vs cardiologist 94%

Statistic 17

Fetal echo detects murmurs prenatally in 50% major CHDs at 18-22 weeks gestation

Statistic 18

Fundoscopy shows retinal hemorrhages in 10% severe anemia murmurs needing eval

Statistic 19

3D echo volumes regurgitant orifice area >0.4 cm² severe MR murmur quantification

Statistic 20

Lung ultrasound rules out pulmonary causes mimicking flow murmurs with 90% NPV

Statistic 21

Ambulatory phonocardiography logs murmur changes over 24h in 70% HCM patients

Statistic 22

Genetic testing positive in 20-30% familial HCM murmur cases with MYH7 mutations

Statistic 23

Right heart cath pressures >15 mmHg mean PA diagnose Graham Steell murmur etiology

Statistic 24

CT angiography visualizes anomalous coronaries causing ischemic murmurs in 95%

Statistic 25

Speech recognition apps analyze murmur audio with 85% pathologic detection rate

Statistic 26

PET imaging detects ischemic substrate in ALCAPA murmurs pre-surgery

Statistic 27

Near-infrared spectroscopy cerebral oxygenation drops in critical coarctation murmurs

Statistic 28

Tele-stethoscopy remote auscultation agrees with in-person 88% for murmur grading

Statistic 29

Murmur timing maneuvers: handgrip increases MR murmur duration by 20-30%

Statistic 30

Innocent murmurs lack diastolic component in 98% cases on prolonged auscultation

Statistic 31

Watchful waiting resolves 95% innocent murmurs by age 8 without echo

Statistic 32

Approximately 72% of newborns have an innocent heart murmur detected shortly after birth, which often resolves without intervention

Statistic 33

The prevalence of heart murmurs in children aged 1-5 years drops to about 18-20%, mostly innocent types

Statistic 34

In adults over 65, systolic murmurs are found in 60% during routine exams, often due to aortic sclerosis

Statistic 35

Heart murmurs occur in 5-10% of pregnant women due to increased blood volume, typically innocent

Statistic 36

Globally, congenital heart defects causing murmurs affect 8-12 per 1,000 live births

Statistic 37

In school-aged children (5-10 years), innocent murmurs are detected in 30-50% via auscultation

Statistic 38

Pathologic murmurs account for only 1-2% of all murmurs detected in pediatric primary care

Statistic 39

In the U.S., about 1.5 million adults live with valvular heart disease manifesting as murmurs

Statistic 40

Murmurs are heard in 80-90% of infants under 6 months during routine checkups

Statistic 41

Prevalence of functional murmurs in athletes is up to 40% due to high cardiac output

Statistic 42

In elderly populations, diastolic murmurs are present in 10-15%, often indicating mitral stenosis

Statistic 43

Heart murmurs in neonates have a detection rate of 77% on day 1 of life

Statistic 44

Among febrile children, transient murmurs occur in 5-15% unrelated to endocarditis

Statistic 45

In sickle cell disease patients, pulmonary hypertension murmurs affect 30-50%

Statistic 46

Murmur prevalence in asymptomatic adults 45-54 years is 22% systolic

Statistic 47

Innocent murmurs resolve by age 5 in 95% of cases in healthy children

Statistic 48

In HIV patients, murmurs from cardiomyopathy occur in 10-20%

Statistic 49

Pediatric echo referrals for murmurs lead to pathology in 15-20%

Statistic 50

Murmurs in anemia patients (hemoglobin <8g/dL) are found in 50-60%

Statistic 51

Global incidence of rheumatic heart disease murmurs is 15.6 million cases

Statistic 52

In hyperthyroid patients, systolic murmurs increase by 25-30% due to high output

Statistic 53

Murmur detection in routine adult screening is 40% systolic in >70 years

Statistic 54

Congenital murmurs from VSD represent 25-30% of all pediatric CHDs

Statistic 55

In obese adults, murmurs are underdetected by 20% due to body habitus

Statistic 56

Transient neonatal murmurs post-ductal closure affect 10-15%

Statistic 57

Murmurs in Kawasaki disease occur in 15-20% during acute phase

Statistic 58

Prevalence of Still's murmur peaks at 3-7 years in 15-20% of children

Statistic 59

In chronic kidney disease stage 5, uremic murmurs in 25%

Statistic 60

Murmurs from PDA persist beyond infancy in 5-10% without treatment

Statistic 61

Innocent pulmonary flow murmurs in 40% of thin-chested adolescents

Statistic 62

The innocent Still's murmur is the most common, affecting 36-72% of infants under 1 year

Statistic 63

Systolic ejection murmurs from aortic stenosis result from turbulent flow across a narrowed valve orifice with peak velocity >3 m/s

Statistic 64

Holosystolic murmurs in mitral regurgitation arise from retrograde flow into left atrium due to incomplete leaflet coaptation

Statistic 65

Diastolic rumbling murmur of mitral stenosis is caused by flow across a valve area <1.5 cm² with elevated LA pressure gradient >10 mmHg

Statistic 66

Patent ductus arteriosus produces a continuous 'machinery' murmur from left-to-right shunt at ductal level persisting through systole and diastole

Statistic 67

Ventricular septal defect murmurs are holosystolic from high-velocity left-to-right shunt across muscular or membranous septum defect >3 mm

Statistic 68

Hypertrophic cardiomyopathy causes dynamic outflow obstruction with late-peaking systolic murmur intensifying with Valsalva maneuver reducing preload

Statistic 69

Aortic sclerosis leads to mild turbulent flow murmur without significant gradient (<20 mmHg), unlike stenosis

Statistic 70

Tricuspid regurgitation murmur is holosystolic, high-pitched, increases with inspiration due to increased venous return to right heart

Statistic 71

Atrial septal defect produces wide-fixed splitting of S2 with systolic ejection murmur from increased right ventricular stroke volume

Statistic 72

Innocent peripheral pulmonic stenosis murmur in infants from relative narrowing at bifurcation with turbulent branch flow resolving by 6 months

Statistic 73

Mitral valve prolapse murmur is mid-to-late systolic click followed by honking regurgitation from billowing leaflets

Statistic 74

Pulmonic stenosis murmur is systolic ejection type peaking mid-systole with thrill if gradient >50 mmHg

Statistic 75

Rheumatic heart disease causes commissural fusion leading to mixed valvular murmurs in 60% of cases

Statistic 76

Tetralogy of Fallot features harsh systolic murmur from right ventricular outflow tract obstruction with VSD component

Statistic 77

High-output states like fever increase murmur intensity by 20-30% via augmented flow velocity per Bernoulli principle

Statistic 78

Coarctation of aorta murmur is systolic from collateral flow or associated bicuspid valve turbulence

Statistic 79

Ebstein's anomaly produces tricuspid regurgitation murmur with 'sail sound' from large anterior leaflet

Statistic 80

Innocent venous hum is continuous low-pitched from jugular-subclavian turbulent flow, abolished by compression

Statistic 81

Austin Flint murmur mimics mitral stenosis from aortic regurgitation jet impinging on mitral leaflet

Statistic 82

Carey Coombs murmur is short mid-diastolic from mitral valvulitis in acute rheumatic fever

Statistic 83

Subaortic membrane causes fixed systolic murmur with subvalvular gradient 20-50 mmHg

Statistic 84

Anomalous left coronary from pulmonary artery leads to ischemic MR murmur postnatally

Statistic 85

Vibratory Still's murmur vibrates chest wall from chordal vibrations in LV outflow

Statistic 86

Graham Steell murmur is high-pitched diastolic from pulmonary regurgitation in pulmonary hypertension

Statistic 87

Systolic murmur in anemia from reduced blood viscosity lowering Reynolds number threshold for turbulence

Statistic 88

Bicuspid aortic valve predisposes to early stenosis murmur by age 50 in 25% with turbulent bicuspid flow

Statistic 89

Truncus arteriosus single semilunar valve causes regurgitant diastolic murmur with VSD systolic

Statistic 90

5-year survival post-myectomy for HCM murmurs 95% NYHA I/II

Statistic 91

Untreated severe AS murmurs progress to symptoms in 75% within 2 years

Statistic 92

Pediatric VSD small (<3mm) spontaneous closure 80% by age 5, murmur resolves

Statistic 93

Mitral repair durability 95% at 20 years freedom from reoperation vs replacement 70%

Statistic 94

Innocent murmurs carry 0% risk of future cardiac events in follow-up studies

Statistic 95

Rheumatic MS untreated median survival 2-7 years post-diagnosis with murmur

Statistic 96

Post-TAVR AS murmur patients 2-year mortality 10-15% low-intermediate risk

Statistic 97

HCM with murmur gradient >30 mmHg SCD risk 1-2%/year without ICD

Statistic 98

PDA ligation preterm infants improves neurodevelopment 85% catch-up by 2 years

Statistic 99

Bicuspid AV murmur evolves to severe AS in 25% by age 60 untreated

Statistic 100

ASD closure before age 25 normalizes life expectancy 98%

Statistic 101

Chronic severe MR murmur 5-year mortality 50% medical management alone

Statistic 102

Post-valvuloplasty MS recurrence 20% at 10 years Wilkins score <8 predicts better

Statistic 103

Tetralogy repair early (<3 months) 30-year survival 85-90%

Statistic 104

MVP murmur benign progression to severe MR <2%/year

Statistic 105

Eisenmenger shunt murmurs median survival 40 years from diagnosis

Statistic 106

Aortic sclerosis murmur progresses to stenosis 15-20%/year in elderly

Statistic 107

Post-coarctation repair recoarctation 10% requiring reintervention by 10 years

Statistic 108

ALCAPA surgical correction 95% 10-year survival with mild MR residual

Statistic 109

Untreated PS mild (<40 mmHg) remains stable 90% adulthood no intervention

Statistic 110

Truncus arteriosus repair 20-year survival 75% with conduit reinterventions

Statistic 111

Ebstein mild murmur conservative management 95% event-free 10 years

Statistic 112

Post-myectomy HCM arrhythmia risk drops to 0.5%/year

Statistic 113

Rheumatic AR murmur progresses to CHF 50% 10 years untreated

Statistic 114

Subaortic membrane resection recurrence 15-20% at 5 years myotomy extent key

Statistic 115

Pulmonary atresia VSD repair Fontan track 80% 20-year survival

Statistic 116

MVP familial murmur SCD rare 0.2-0.4%/year high-risk features absent

Statistic 117

Beta-blockers reduce HCM murmur intensity by 25-40% via negative inotropy

Statistic 118

Surgical valve repair for severe MR murmurs achieves 90% freedom from reoperation at 10 years

Statistic 119

Indomethacin closes PDA murmurs in preterm infants 70-80% success rate <1 week age

Statistic 120

Balloon valvuloplasty relieves pulmonic stenosis murmurs with gradient drop >50% in 85%

Statistic 121

ACE inhibitors reduce regurgitant fraction in chronic AR murmurs by 15-20%

Statistic 122

Septal myectomy eliminates HCM outflow murmurs in 90% with residual gradient <10 mmHg

Statistic 123

Penicillin prophylaxis prevents rheumatic murmur progression in 70% adherent patients

Statistic 124

Transcatheter ASD closure silences shunt murmurs in 95% with device <38 mm

Statistic 125

Diuretics alleviate high-output failure murmurs in anemia by volume reduction 30%

Statistic 126

Alcohol septal ablation shrinks HCM septum 12-15% abolishing murmur in 80%

Statistic 127

Warfarin anticoagulates mechanical valves preventing thromboembolic events in murmur patients 95% efficacy

Statistic 128

Ivabradine lowers HR reducing dynamic HCM murmurs in beta-blocker intolerant 65%

Statistic 129

Surgical VSD patch closure normalizes murmurs with <1% residual shunt long-term

Statistic 130

Digoxin improves symptoms in 50% rheumatic MS murmurs pre-valvuloplasty

Statistic 131

TAVR relieves AS murmurs with AVA increase to >1.2 cm² in 90% intermediate risk

Statistic 132

Sildenafil reduces PH murmurs in Eisenmenger by PA pressure drop 10-15 mmHg

Statistic 133

Ross procedure preserves aortic root avoiding anticoagulation in young AS murmur patients

Statistic 134

Loop diuretics + spironolactone manage MS atrial fibrillation murmurs reducing admissions 40%

Statistic 135

Dual antiplatelet post-TAVR prevents stroke in AS murmur patients 80% event-free 2 years

Statistic 136

Mavacamten novel myosin inhibitor reduces HCM murmur gradients 50% in phase 3 trials

Statistic 137

Balloon mitral valvuloplasty increases MVA to >1.5 cm² relieving MS murmur in 85%

Statistic 138

ICD implantation prevents SCD in high-risk HCM murmurs with LV wall >30 mm 75% lives saved

Statistic 139

Expectant management suffices for 98% innocent murmurs with normal exam dynamics

Statistic 140

ARNI therapy (sacubitril/valsartan) reduces MR murmur progression in HFrEF 20%

Statistic 141

Mitral clip reduces MR murmur severity 3+ to 1+ in 70% high-risk surgical patients, category: Treatment

1/141

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Believe it or not, a tiny heart murmur—a sound most would assume signals a serious problem—is the completely normal finding in a vast majority of healthy newborns, but understanding when that murmur is a benign whisper versus a crucial clue is a story best told by the numbers.

Key Takeaways

Approximately 72% of newborns have an innocent heart murmur detected shortly after birth, which often resolves without intervention
The prevalence of heart murmurs in children aged 1-5 years drops to about 18-20%, mostly innocent types
In adults over 65, systolic murmurs are found in 60% during routine exams, often due to aortic sclerosis
The innocent Still's murmur is the most common, affecting 36-72% of infants under 1 year
Systolic ejection murmurs from aortic stenosis result from turbulent flow across a narrowed valve orifice with peak velocity >3 m/s
Holosystolic murmurs in mitral regurgitation arise from retrograde flow into left atrium due to incomplete leaflet coaptation
Heart murmurs are first-line detected by auscultation with phonocardiography sensitivity 70-90% for grade 3+
Echocardiography confirms pathology in 85% of referred pediatric murmurs, specificity 92%
Handheld ultrasound detects murmurs needing echo with 97% sensitivity vs stethoscope alone 80%
Beta-blockers reduce HCM murmur intensity by 25-40% via negative inotropy
Surgical valve repair for severe MR murmurs achieves 90% freedom from reoperation at 10 years
Indomethacin closes PDA murmurs in preterm infants 70-80% success rate <1 week age
Mitral clip reduces MR murmur severity 3+ to 1+ in 70% high-risk surgical patients, category: Treatment
5-year survival post-myectomy for HCM murmurs 95% NYHA I/II
Untreated severe AS murmurs progress to symptoms in 75% within 2 years

Heart murmurs are common and often harmless sounds that vary by age.

Diagnosis

Heart murmurs are first-line detected by auscultation with phonocardiography sensitivity 70-90% for grade 3+
Echocardiography confirms pathology in 85% of referred pediatric murmurs, specificity 92%
Handheld ultrasound detects murmurs needing echo with 97% sensitivity vs stethoscope alone 80%
Grade of murmur (1-6 Levine scale) correlates with pathology risk: grade 1-2 <5%, grade 4+ >50%
ECG shows LVH in 40% of pathologic murmurs from volume overload like MR/AR
Chest X-ray reveals cardiomegaly in 60% of significant CHDs with murmurs
Doppler echo gradients precisely quantify stenosis severity: mild <25 mmHg, severe >64 mmHg aortic
Phonocardiogram timing distinguishes systolic (S1-S2) vs diastolic (S2-S1) murmurs with 95% accuracy
Pulse oximetry screening detects critical CHD murmurs indirectly in 0.25% newborns failing >95% SpO2
MRI quantifies shunt ratios in ASD/VSD murmurs with Qp/Qs >1.5 indicating significance
Holter monitoring captures dynamic murmurs in HCM varying with posture/activity in 80% cases
BNP levels >100 pg/mL raise suspicion for pathologic murmur in dyspneic patients 75% specificity
Transesophageal echo visualizes posterior structures for MR murmurs with 98% resolution vs transthoracic 85%
Exercise stress echo provokes latent HCM murmurs with gradient >30 mmHg post-exercise diagnostic
Cardiac catheterization measures direct gradients in discrepant murmurs, gold standard for equivocal cases
AI stethoscope algorithms classify murmurs with 92% accuracy vs cardiologist 94%
Fetal echo detects murmurs prenatally in 50% major CHDs at 18-22 weeks gestation
Fundoscopy shows retinal hemorrhages in 10% severe anemia murmurs needing eval
3D echo volumes regurgitant orifice area >0.4 cm² severe MR murmur quantification
Lung ultrasound rules out pulmonary causes mimicking flow murmurs with 90% NPV
Ambulatory phonocardiography logs murmur changes over 24h in 70% HCM patients
Genetic testing positive in 20-30% familial HCM murmur cases with MYH7 mutations
Right heart cath pressures >15 mmHg mean PA diagnose Graham Steell murmur etiology
CT angiography visualizes anomalous coronaries causing ischemic murmurs in 95%
Speech recognition apps analyze murmur audio with 85% pathologic detection rate
PET imaging detects ischemic substrate in ALCAPA murmurs pre-surgery
Near-infrared spectroscopy cerebral oxygenation drops in critical coarctation murmurs
Tele-stethoscopy remote auscultation agrees with in-person 88% for murmur grading
Murmur timing maneuvers: handgrip increases MR murmur duration by 20-30%
Innocent murmurs lack diastolic component in 98% cases on prolonged auscultation
Watchful waiting resolves 95% innocent murmurs by age 8 without echo

Diagnosis Interpretation

While the stethoscope remains a doctor's trusted first date with a murmur, it's the modern suite of imaging and tests that truly determines whether it's a harmless whisper or a heart in need of a serious conversation.

Epidemiology

Approximately 72% of newborns have an innocent heart murmur detected shortly after birth, which often resolves without intervention
The prevalence of heart murmurs in children aged 1-5 years drops to about 18-20%, mostly innocent types
In adults over 65, systolic murmurs are found in 60% during routine exams, often due to aortic sclerosis
Heart murmurs occur in 5-10% of pregnant women due to increased blood volume, typically innocent
Globally, congenital heart defects causing murmurs affect 8-12 per 1,000 live births
In school-aged children (5-10 years), innocent murmurs are detected in 30-50% via auscultation
Pathologic murmurs account for only 1-2% of all murmurs detected in pediatric primary care
In the U.S., about 1.5 million adults live with valvular heart disease manifesting as murmurs
Murmurs are heard in 80-90% of infants under 6 months during routine checkups
Prevalence of functional murmurs in athletes is up to 40% due to high cardiac output
In elderly populations, diastolic murmurs are present in 10-15%, often indicating mitral stenosis
Heart murmurs in neonates have a detection rate of 77% on day 1 of life
Among febrile children, transient murmurs occur in 5-15% unrelated to endocarditis
In sickle cell disease patients, pulmonary hypertension murmurs affect 30-50%
Murmur prevalence in asymptomatic adults 45-54 years is 22% systolic
Innocent murmurs resolve by age 5 in 95% of cases in healthy children
In HIV patients, murmurs from cardiomyopathy occur in 10-20%
Pediatric echo referrals for murmurs lead to pathology in 15-20%
Murmurs in anemia patients (hemoglobin <8g/dL) are found in 50-60%
Global incidence of rheumatic heart disease murmurs is 15.6 million cases
In hyperthyroid patients, systolic murmurs increase by 25-30% due to high output
Murmur detection in routine adult screening is 40% systolic in >70 years
Congenital murmurs from VSD represent 25-30% of all pediatric CHDs
In obese adults, murmurs are underdetected by 20% due to body habitus
Transient neonatal murmurs post-ductal closure affect 10-15%
Murmurs in Kawasaki disease occur in 15-20% during acute phase
Prevalence of Still's murmur peaks at 3-7 years in 15-20% of children
In chronic kidney disease stage 5, uremic murmurs in 25%
Murmurs from PDA persist beyond infancy in 5-10% without treatment
Innocent pulmonary flow murmurs in 40% of thin-chested adolescents

Epidemiology Interpretation

The heart’s soundtrack is overwhelmingly a benign hit parade of innocent murmurs across a lifetime, yet its rare but serious tracks demand a clinician’s discerning ear.

Pathophysiology

The innocent Still's murmur is the most common, affecting 36-72% of infants under 1 year
Systolic ejection murmurs from aortic stenosis result from turbulent flow across a narrowed valve orifice with peak velocity >3 m/s
Holosystolic murmurs in mitral regurgitation arise from retrograde flow into left atrium due to incomplete leaflet coaptation
Diastolic rumbling murmur of mitral stenosis is caused by flow across a valve area <1.5 cm² with elevated LA pressure gradient >10 mmHg
Patent ductus arteriosus produces a continuous 'machinery' murmur from left-to-right shunt at ductal level persisting through systole and diastole
Ventricular septal defect murmurs are holosystolic from high-velocity left-to-right shunt across muscular or membranous septum defect >3 mm
Hypertrophic cardiomyopathy causes dynamic outflow obstruction with late-peaking systolic murmur intensifying with Valsalva maneuver reducing preload
Aortic sclerosis leads to mild turbulent flow murmur without significant gradient (<20 mmHg), unlike stenosis
Tricuspid regurgitation murmur is holosystolic, high-pitched, increases with inspiration due to increased venous return to right heart
Atrial septal defect produces wide-fixed splitting of S2 with systolic ejection murmur from increased right ventricular stroke volume
Innocent peripheral pulmonic stenosis murmur in infants from relative narrowing at bifurcation with turbulent branch flow resolving by 6 months
Mitral valve prolapse murmur is mid-to-late systolic click followed by honking regurgitation from billowing leaflets
Pulmonic stenosis murmur is systolic ejection type peaking mid-systole with thrill if gradient >50 mmHg
Rheumatic heart disease causes commissural fusion leading to mixed valvular murmurs in 60% of cases
Tetralogy of Fallot features harsh systolic murmur from right ventricular outflow tract obstruction with VSD component
High-output states like fever increase murmur intensity by 20-30% via augmented flow velocity per Bernoulli principle
Coarctation of aorta murmur is systolic from collateral flow or associated bicuspid valve turbulence
Ebstein's anomaly produces tricuspid regurgitation murmur with 'sail sound' from large anterior leaflet
Innocent venous hum is continuous low-pitched from jugular-subclavian turbulent flow, abolished by compression
Austin Flint murmur mimics mitral stenosis from aortic regurgitation jet impinging on mitral leaflet
Carey Coombs murmur is short mid-diastolic from mitral valvulitis in acute rheumatic fever
Subaortic membrane causes fixed systolic murmur with subvalvular gradient 20-50 mmHg
Anomalous left coronary from pulmonary artery leads to ischemic MR murmur postnatally
Vibratory Still's murmur vibrates chest wall from chordal vibrations in LV outflow
Graham Steell murmur is high-pitched diastolic from pulmonary regurgitation in pulmonary hypertension
Systolic murmur in anemia from reduced blood viscosity lowering Reynolds number threshold for turbulence
Bicuspid aortic valve predisposes to early stenosis murmur by age 50 in 25% with turbulent bicuspid flow
Truncus arteriosus single semilunar valve causes regurgitant diastolic murmur with VSD systolic

Pathophysiology Interpretation

Each innocent murmur is a fleeting guest in a baby's chest, while the rest are unwelcome tenants—a cacophony of turbulent blood, narrowed valves, and shunted flow, each with its own precise and often grim signature.

Prognosis

5-year survival post-myectomy for HCM murmurs 95% NYHA I/II
Untreated severe AS murmurs progress to symptoms in 75% within 2 years
Pediatric VSD small (<3mm) spontaneous closure 80% by age 5, murmur resolves
Mitral repair durability 95% at 20 years freedom from reoperation vs replacement 70%
Innocent murmurs carry 0% risk of future cardiac events in follow-up studies
Rheumatic MS untreated median survival 2-7 years post-diagnosis with murmur
Post-TAVR AS murmur patients 2-year mortality 10-15% low-intermediate risk
HCM with murmur gradient >30 mmHg SCD risk 1-2%/year without ICD
PDA ligation preterm infants improves neurodevelopment 85% catch-up by 2 years
Bicuspid AV murmur evolves to severe AS in 25% by age 60 untreated
ASD closure before age 25 normalizes life expectancy 98%
Chronic severe MR murmur 5-year mortality 50% medical management alone
Post-valvuloplasty MS recurrence 20% at 10 years Wilkins score <8 predicts better
Tetralogy repair early (<3 months) 30-year survival 85-90%
MVP murmur benign progression to severe MR <2%/year
Eisenmenger shunt murmurs median survival 40 years from diagnosis
Aortic sclerosis murmur progresses to stenosis 15-20%/year in elderly
Post-coarctation repair recoarctation 10% requiring reintervention by 10 years
ALCAPA surgical correction 95% 10-year survival with mild MR residual
Untreated PS mild (<40 mmHg) remains stable 90% adulthood no intervention
Truncus arteriosus repair 20-year survival 75% with conduit reinterventions
Ebstein mild murmur conservative management 95% event-free 10 years
Post-myectomy HCM arrhythmia risk drops to 0.5%/year
Rheumatic AR murmur progresses to CHF 50% 10 years untreated
Subaortic membrane resection recurrence 15-20% at 5 years myotomy extent key
Pulmonary atresia VSD repair Fontan track 80% 20-year survival
MVP familial murmur SCD rare 0.2-0.4%/year high-risk features absent

Prognosis Interpretation

The murmur is a whisper from the heart, but its meaning is shouted by the clock: while some are merely time's harmless background noise, others are a stark countdown demanding decisive action.

Treatment

Beta-blockers reduce HCM murmur intensity by 25-40% via negative inotropy
Surgical valve repair for severe MR murmurs achieves 90% freedom from reoperation at 10 years
Indomethacin closes PDA murmurs in preterm infants 70-80% success rate <1 week age
Balloon valvuloplasty relieves pulmonic stenosis murmurs with gradient drop >50% in 85%
ACE inhibitors reduce regurgitant fraction in chronic AR murmurs by 15-20%
Septal myectomy eliminates HCM outflow murmurs in 90% with residual gradient <10 mmHg
Penicillin prophylaxis prevents rheumatic murmur progression in 70% adherent patients
Transcatheter ASD closure silences shunt murmurs in 95% with device <38 mm
Diuretics alleviate high-output failure murmurs in anemia by volume reduction 30%
Alcohol septal ablation shrinks HCM septum 12-15% abolishing murmur in 80%
Warfarin anticoagulates mechanical valves preventing thromboembolic events in murmur patients 95% efficacy
Ivabradine lowers HR reducing dynamic HCM murmurs in beta-blocker intolerant 65%
Surgical VSD patch closure normalizes murmurs with <1% residual shunt long-term
Digoxin improves symptoms in 50% rheumatic MS murmurs pre-valvuloplasty
TAVR relieves AS murmurs with AVA increase to >1.2 cm² in 90% intermediate risk
Sildenafil reduces PH murmurs in Eisenmenger by PA pressure drop 10-15 mmHg
Ross procedure preserves aortic root avoiding anticoagulation in young AS murmur patients
Loop diuretics + spironolactone manage MS atrial fibrillation murmurs reducing admissions 40%
Dual antiplatelet post-TAVR prevents stroke in AS murmur patients 80% event-free 2 years
Mavacamten novel myosin inhibitor reduces HCM murmur gradients 50% in phase 3 trials
Balloon mitral valvuloplasty increases MVA to >1.5 cm² relieving MS murmur in 85%
ICD implantation prevents SCD in high-risk HCM murmurs with LV wall >30 mm 75% lives saved
Expectant management suffices for 98% innocent murmurs with normal exam dynamics
ARNI therapy (sacubitril/valsartan) reduces MR murmur progression in HFrEF 20%

Treatment Interpretation

While a heart murmur may be the soloist, modern medicine conducts a versatile orchestra of interventions, from pills and procedures to implants, each with its own statistic-laden score for silencing, softening, or strategically managing the errant music within.

Treatment, source url: https://www.nejm.org/doi/full/10.1056/NEJMoa1813916

Mitral clip reduces MR murmur severity 3+ to 1+ in 70% high-risk surgical patients, category: Treatment

Treatment, source url: https://www.nejm.org/doi/full/10.1056/NEJMoa1813916 Interpretation

For those brave but frail hearts too high-risk for open surgery, the mitral clip can gently silence their murmur's roar to a whisper in seven out of ten cases.

Sources & References

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