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Ejection Systolic Heart Murmur

MedGen UID:
1389228
•Concept ID:
C0694547
•
Finding
Synonym: Systolic ejection murmur

Definition

A heart murmur that occurs predominantly in midsystole, when ejection volume and velocity of blood flow are at their maximum; it is produced by ejection of blood into the pulmonary artery and aorta. It is typically crescendo-decrescendo. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVEjection Systolic Heart Murmur

Professional guidelines

PubMed

A review of the pathophysiology, diagnosis, and treatment of aortic valve stenosis in elderly patients.
Aronow WS
Hosp Pract (1995) 2013 Oct-Nov;41(4):66-77. doi: 10.3810/hp.2013.10.1082. PMID: 24145591
Diagnosis and management of acyanotic heart disease: part II -- left-to-right shunt lesions.
Syamasundar Rao P
Indian J Pediatr 2005 Jun;72(6):503-12. doi: 10.1007/BF02724429. PMID: 15985740
Diagnosis and management of acyanotic heart disease: part I -- obstructive lesions.
Syamasundar Rao P
Indian J Pediatr 2005 Jun;72(6):496-502. PMID: 15985739

Recent clinical studies

Etiology

Accidental Heart Murmurs.
Begic E, Begic Z
Med Arch 2017 Aug;71(4):284-287. doi: 10.5455/medarh.2017.71.284-287. PMID: 28974851Free PMC Article
Aortic stenosis.
Aronow WS
Compr Ther 2007 Winter;33(4):174-83. doi: 10.1007/s12019-007-8021-8. PMID: 18025609
Aortic sclerosis: not an innocent murmur but a marker of increased cardiovascular risk.
Nightingale AK, Horowitz JD
Heart 2005 Nov;91(11):1389-93. Epub 2005 Mar 29 doi: 10.1136/hrt.2004.057117. PMID: 15797932Free PMC Article
Correlation of prevalence and severity of valvular aortic stenosis determined by continuous-wave Doppler echocardiography with physical signs of aortic stenosis in patients aged 62 to 100 years with aortic systolic ejection murmurs.
Aronow WS, Kronzon I
Am J Cardiol 1987 Aug 1;60(4):399-401. doi: 10.1016/0002-9149(87)90262-1. PMID: 3497570
Correlation of aortic cuspal and aortic root disease with aortic systolic ejection murmurs and with mitral anular calcium in persons older than 62 years in a long-term health care facility.
Aronow WS, Schwartz KS, Koenigsberg M
Am J Cardiol 1986 Sep 15;58(7):651-2. doi: 10.1016/0002-9149(86)90295-x. PMID: 3751938

Diagnosis

Accidental Heart Murmurs.
Begic E, Begic Z
Med Arch 2017 Aug;71(4):284-287. doi: 10.5455/medarh.2017.71.284-287. PMID: 28974851Free PMC Article
Cardiac pearls.
Harvey WP
Dis Mon 1994 Feb;40(2):41-113. doi: 10.1016/0011-5029(94)90002-7. PMID: 8306847
Cardiac auscultation: opening snaps, systolic clicks, and ejection sounds.
Ronan JA Jr
Heart Dis Stroke 1993 May-Jun;2(3):188-91. PMID: 8137024
Mitral valve regurgitation.
O'Rourke RA, Crawford MH
Curr Probl Cardiol 1984 May;9(2):1-52. doi: 10.1016/0146-2806(84)90021-5. PMID: 6375982
Late systolic murmurs and non-ejection ("mid-late") systolic clicks. An analysis of 90 patients.
Barlow JB, Bosman CK, Pocock WA, Marchand P
Br Heart J 1968 Mar;30(2):203-18. doi: 10.1136/hrt.30.2.203. PMID: 5642419Free PMC Article

Therapy

Aortic stenosis.
Aronow WS
Compr Ther 2007 Winter;33(4):174-83. doi: 10.1007/s12019-007-8021-8. PMID: 18025609
Isolated interrupted aortic arch: a case report and review of the literature.
Akdemir R, Ozhan H, Erbilen E, Yazici M, Gündüz H, Uyan C
Int J Cardiovasc Imaging 2004 Oct;20(5):389-92. doi: 10.1023/b:caim.0000041940.14780.1c. PMID: 15765861
Cardiac pearls.
Harvey WP
Dis Mon 1994 Feb;40(2):41-113. doi: 10.1016/0011-5029(94)90002-7. PMID: 8306847
Mitral valve regurgitation.
O'Rourke RA, Crawford MH
Curr Probl Cardiol 1984 May;9(2):1-52. doi: 10.1016/0146-2806(84)90021-5. PMID: 6375982
Calcified postoperative epicardial granuloma.
Roe BB
Ann Thorac Surg 1975 Apr;19(4):472-3. doi: 10.1016/s0003-4975(10)64051-9. PMID: 1092280

Prognosis

Does Iron Deficiency Affect the Heart in Children?
Demir F, Kayali S, Gokcebay DG
J Pediatr Hematol Oncol 2022 Apr 1;44(3):84-88. doi: 10.1097/MPH.0000000000002170. PMID: 33843814
Intracardiac leiomyomatosis: iliac vein to right-ventricular outflow tract.
Bennett ES, Arora NS, Kay M, Robinson TT, Fergus I
Nat Clin Pract Cardiovasc Med 2005 Jul;2(7):369-72; quiz 373. doi: 10.1038/ncpcardio0250. PMID: 16265563
Aortic sclerosis: not an innocent murmur but a marker of increased cardiovascular risk.
Nightingale AK, Horowitz JD
Heart 2005 Nov;91(11):1389-93. Epub 2005 Mar 29 doi: 10.1136/hrt.2004.057117. PMID: 15797932Free PMC Article
Long-term results of balloon pulmonary valvuloplasty of valvar pulmonic stenosis.
Rao PS, Fawzy ME, Solymar L, Mardini MK
Am Heart J 1988 Jun;115(6):1291-6. doi: 10.1016/0002-8703(88)90023-3. PMID: 3376847
Mitral valve regurgitation.
O'Rourke RA, Crawford MH
Curr Probl Cardiol 1984 May;9(2):1-52. doi: 10.1016/0146-2806(84)90021-5. PMID: 6375982

Clinical prediction guides

Does Iron Deficiency Affect the Heart in Children?
Demir F, Kayali S, Gokcebay DG
J Pediatr Hematol Oncol 2022 Apr 1;44(3):84-88. doi: 10.1097/MPH.0000000000002170. PMID: 33843814
S-Nitrosylation of Histone Deacetylase 2 by Neuronal Nitric Oxide Synthase as a Mechanism of Diastolic Dysfunction.
Yoon S, Kim M, Lee H, Kang G, Bedi K, Margulies KB, Jain R, Nam KI, Kook H, Eom GH
Circulation 2021 May 11;143(19):1912-1925. Epub 2021 Mar 10 doi: 10.1161/CIRCULATIONAHA.119.043578. PMID: 33715387
Screening for aortic stenosis using physical examination and echocardiography.
Abe Y
J Echocardiogr 2021 Jun;19(2):80-85. Epub 2021 Jan 7 doi: 10.1007/s12574-020-00511-8. PMID: 33415574
Systolic ejection click versus split first heart sound: Are our ears deceiving us?
Hoeting NM, McCracken CE, McConnell M, Sallee D, Iannucci GJ, Oster ME
Congenit Heart Dis 2017 Jul;12(4):417-420. Epub 2017 Mar 16 doi: 10.1111/chd.12460. PMID: 28299882
Cardiac pearls.
Harvey WP
Dis Mon 1994 Feb;40(2):41-113. doi: 10.1016/0011-5029(94)90002-7. PMID: 8306847

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