A holosystolic murmur begins at the first heart sound (S1) and continue to the second heart sound (S2), as illustrated in the phonocardiogram. Typically high-pitched, these murmurs are usually caused by ventricular septal defect, mitral regurgitation or tricuspid regurgitation, as discussed below.
Ventricular Septal Defect
Ventricular Septal Defect (VSD) is a congenital condition associated with abnormal blood flow between the left ventricle and the right ventricle due to a shunt (hole) in the wall that separates the right and left ventricles. Holosystolic murmurs can be auscultated over the left 3rd and 4th intercostal spaces and along the sternal border.
To listen to a holosystolic murmur caused by ventricular septal detect:
Ventricular Septal Defect Lesson
To observe a phonocardiogram of the murmur:
Ventricular Septal Defect Phonocardiogram
To watch a cardiac animation of VSD:
Ventricular Septal Defect Animation
The murmur in mitral regurgitation is high or mid frequency and best heard at the apex with diaphragm of the stethoscope. Place the patient in the lateral decubitus position.
Our courses provide two lessons on two types of mitral regurgitation: normal and severe.
Tricuspid regurgitation murmurs can include both a holosystolic murmur and a diastolic murmur. Auscultate this murmur over the fourth left sternal border. The holosystolic murmur in the lesson found below is loud and continuous throughout systole.
To listen to a holosystolic murmur caused by ventricular septal detect and to review a lesson on tricuspid regurgitation, follow this link:
Tricuspid Regurgitation Lesson