Editing Heart murmur (section)

====Systolic====

{{Main|Systolic heart murmur}}

*[[Aortic valve stenosis]] is a crescendo/decrescendo systolic murmur. It is best heard at the right upper sternal border (aortic area). It sometimes radiates to the carotid arteries. In mild aortic stenosis, the crescendo-decrescendo is early peaking. Whereas in severe aortic stenosis, the crescendo is late-peaking. In severe cases, obliteration of the S2 heart sound may occur.
*[[Aortic valve stenosis|Stenosis]] of [[Bicuspid aortic valve]] is like the aortic valve stenosis heart murmur. But, one may hear a systolic ejection click after S1 in calcified bicuspid aortic valves. Symptoms tend to present between 40 and 70 years of age.
*[[Mitral regurgitation]] is a [[holosystolic murmur]]. One can best hear it at the apex location and it may radiate to the axilla or precordium. When associated with [[mitral valve prolapse]], one may hear a systolic click. In this scenario, valsalva maneuver will decrease left ventricular preload. This will move the murmur onset closer to S1. Isometric handgrip will increase left ventricular afterload. This will increase murmur intensity. In acute severe mitral regurgitation, one may not hear a holosystolic murmur.
*[[Pulmonary valve stenosis]] is a crescendo-decrescendo systolic murmur. One can hear it best at the left upper sternal border. It has association with a systolic ejection click that increases with inspiration. This finding results from an increased venous return to the right side of the heart. Pulmonary stenosis sometimes radiates to the left clavicle.
*[[Tricuspid insufficiency|Tricuspid valve regurgitation]] is a holosystolic murmur. It presents at the left lower sternal border with radiation to the left upper sternal border. One may see prominent v and c waves in the JVP (jugular venous pressure). The murmur will increase with inspiration.
*[[Hypertrophic obstructive cardiomyopathy]] (or hypertrophic subaortic stenosis) will be a systolic crescendo-decrescendo murmur. One can best hear it at the left lower sternal border. Valsalva maneuver will increase the intensity of the murmur. Going from squatting to standing will also increase the intensity of the murmur.
*[[Atrial septal defect]] will present with a systolic crescendo-decrescendo murmur. It is best heard at the left upper sternal border. This is the result of an increased volume going through the pulmonary valve. It has association with a fixed, split S2 and a right ventricular heave.
*[[Ventricular septal defect]] (VSD) will present as a holosystolic murmur. One can hear it at the left lower sternal border. It has association with a palpable thrill, and increases with isometric handgrip. A right to left shunt ([[Eisenmenger syndrome]]) may develop with uncorrected VSDs. This is due to worsening [[pulmonary hypertension]]. Pulmonary hypertension will increase the murmur intensity and may present with cyanosis.
*[[Functional murmur|Flow murmur]] presents at the right upper sternal border. It may present in certain conditions, such as anemia, hyperthyroidism, fever, and pregnancy.