Evaluating Cardiac Murmurs

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Once you have identified which murmur…

  • A murmur is (technically) NOT a diagnosis but a sign.  Therefore you should ask WHY is there a murmur.  This may involve further investigation e.g.
    • Echocardiogram – will often further evaluate the severity and impact of a murmur but may not provide a cause.
    • Imaging- e.g. CTPA (particularly if SOB and pulmonary regurgitation- to rule out PE as cause)
    • ECG- may show signs of past infarction which may explain a murmur
  • Management of murmurs really depends on the underlying cause and whether it is reversible.  It also depends on the impact of the murmur on cardiac function.  A large number are managed conservatively (particularly idiopathic aortic stenosis), although it is a good idea to manage any underlying risk factors for cardiac disease e.g. cholesterol, blood pressure, weight, etc.

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