Most<unk><unk>  are
Not holo or diastolic
Not >grade III
Hockey stick dist
Normal S1 & S2
Not holo or diastolic
Not >grade III
Hockey stick dist
Normal S1 & S2
Mid-Systolic, best at left lower sternal border, likely from harmonic vibrations of LV outflow tract (chordae tindinae)
All ages, particularly young school age
Low pitch, musical
Decreased with inspiration, sitting, standing. Not a VSD- not regurgitant or with thrill
Systolic best at left upper sternal border, minor turbulence in RV outflow tract and main pulmonary artery
Often infants and preschool age. Higher pitched than still's, less musical
Not PS- no ejection click, no increased RV impulse. no wide s2 split
Not Pulm M of ASD, no fixed splitting, no diastolic tricuspid flow rumble, no increased RV impulse
Decreased on inspiration/sitting/standing
Systolic ejection<unk> from turbulence in pulmonary artery branches (one or both)
Medium pitch
Physiologic in neonates, becoming audible at L,R,B USB between 0-2wks
Transmits well to back and axilla. common in premature; disappears early in infancy
Not PS- no ejection click, no increase in RV impulse
Systolic ejection<unk> of medium pitch from physiologic turbulence of carotid/subclavian and heard at base of neck
Can be palpable. Disappears on hyperextension of shoulders
Not AS which is loudest at URSB with systolic thrill, sometimes with click
Continuous<unk> from turbulent flow in SVC heard at L,R,or B infraclavicular position while sitting/standing
Not PDA (bounding pulse, systolic>diastolic sound) or AV malformation
Disappears in recumbent position, rotation of head, by pressure at jugular
Blood flow in A and V to engorged breast
Systolic or continuous, disappears with stethoscope pressure
High pitched cooing, anywhere, but especially apex
Breath sound so not timed to heart, disappear when holding breath
Innocent pediatric murmurs
Mitral stenosis
Stone heart
Mitral regurgitation
Anomalous coronary arteries
Mitral valve prolapse
Arrhythmogenic right ventricular dysplasia
Aortic stenosis