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1. A soft sound, like that made by a somewhat forcible expiration with the mouth open, heard on auscultation of the heart, lungs, or blood vessel s. SYN: susurrus. 2. An other-than-soft sound, which may be loud, harsh, frictional, etc.; e.g., organic cardiac murmurs may be soft or loud and harsh; pericardial murmurs usually are frictional and are more properly described as “rubs” rather than murmurs. [L.]

- accidental m. an evanescent cardiac m. not due to valvular lesion.

- anemic m. a nonvalvular m. heard on auscultation of the heart and large blood vessel s in cases of profound anemia associated mainly with turbulent blood flow due to decreased blood viscosity.

- aneurysmal m. a systolic or systolic-diastolic m. heard over some cardiac aneurysms.

- aortic m. a m. produced at the aortic orifice, either obstructive or regurgitant.

- arterial m. a m. heard on auscultating an artery.

- atriosystolic m. SYN: presystolic m..

- Austin Flint m. SYN: Austin Flint phenomenon, Flint m..

- bellows m. a blowing m..

- brain m. sounds produced by intracranial aneurysms or arterial venous aneurysms in congenital dysplastic angiomatosis.

- Cabot-Locke m. an early diastolic m., like that of aortic insufficiency, heard best at the left lower sternal border in severe anemia.

- cardiac m. a m. produced within the heart, at one of its valvular orifices or across ventricular septal defects.

- cardiopulmonary m. an innocent extracardiac m., synchronous with the heart's beat but disappearing when the breath is held, believed due to movement of air in a segment of lung compressed by the contracting heart. SYN: cardiorespiratory m..

- cardiorespiratory m. SYN: cardiopulmonary m..

- Carey Coombs m. a blubbering apical middiastolic m. occurring in the acute stage of rheumatic mitral valvulitis and disappearing as the valvulitis subsides. SYN: Coombs m..

- Cole-Cecil m. the diastolic m. of aortic insufficiency when well or predominantly heard in the left axilla.

- continuous m. a m. that is heard without interruption throughout systole and into diastole.

- cooing m. a m., usually of mitral regurgitation, of very high pitch resembling the cooing of a pigeon or a dove.

- Coombs m. SYN: Carey Coombs m..

- crescendo m. a m. that increases in intensity and suddenly ceases; the presystolic m. of mitral stenosis is a common example.

- Cruveilhier-Baumgarten m. a venous m. heard over collateral veins, connecting portal and caval venous systems, on the abdominal wall. SEE ALSO: Cruveilhier-Baumgarten sign.

- diamond-shaped m. a crescendo-decrescendo m., from the shape of the frequency intensity curve of the phonocardiogram, often audible as such.

- diastolic m. (DM) a m. heard during diastole.

- Duroziez m. a two-phase m. over peripheral arteries, especially the femoral artery, due to rapid ebb and flow of blood during aortic insufficiency. SYN: Duroziez sign.

- dynamic m. a heart m. due to anemia or to any cause other than a valvular lesion.

- early diastolic m. a m. that begins with the second heart sound, as the m. of aortic insufficiency.

- ejection m. a diamond-shaped systolic m. produced by the ejection of blood into the aorta or pulmonary artery and ending by the time of the second heart sound component produced, respectively, by closing of the aortic or pulmonic valve.

- endocardial m. a m. arising, from any cause, within the heart.

- extracardiac m. a bruit heard over or near the precordium originating from structures other than the heart; the term includes pericardial friction rubs and cardiopulmonary murmurs.

- Flint m. a diastolic m., similar to that of mitral stenosis, heard best at the cardiac apex in some cases of free aortic insufficiency; it is thought to be caused by the turbulent regurgitating stream from the aorta mixing into the stream simultaneously entering from the left atrium through the mitral valve, causing posterior movement of the anterior leaflet of the mitral valve with transient acceleration of blood flow through the mitral valve. SYN: Austin Flint m..

- Fräntzel m. m. of mitral stenosis when louder at its beginning and end than in its midportion.

- friction m. SYN: friction sound.

- functional m. a cardiac m. not associated with a significant heart lesion. SYN: innocent m., inorganic m..

- Gibson m. the typical continuous “machinerylike” m. of patent ductus arteriosus.

- Graham Steell m. an early diastolic m. of pulmonic insufficiency secondary to pulmonary hypertension, as in mitral stenosis and various congenital defects associated with pulmonary hypertension. SYN: Steell m..

- Hamman m. a crunching precordial sound synchronous with the heart beat; heard in mediastinal emphysema; also known as Hamman crunch.

- hemic m. a cardiac or vascular m. heard in anemic persons who have no valvular lesion, probably due to the increased blood velocity and turbulence that characterizes anemia.

- Hodgkin-Key m. a musical diastolic m. associated with retroversion of an aortic cusp; often very loud.

- holosystolic m. SYN: pansystolic m..

- hourglass m. one in which there are two areas of maximum loudness decreasing to a point midway between the two.

- innocent m. SYN: functional m..

- inorganic m. SYN: functional m..

- late apical systolic m. a m. previously considered benign, or even extracardiac, with a possible relationship to pericardial disease; it often represents mitral insufficiency, often localized and of moderate severity but with propensity for developing bacterial endocarditis, and is frequently associated with systolic click and mitral prolapse (Barlow syndrome; a balloon or billowing mitral valve leaflet) often producing a click, m., or both, as it prolapses during systole into the left atrium.

- late diastolic m. SYN: presystolic m..

- machinery m. the long “continuous” rumbling m. of patent ductus arteriosus.

- middiastolic m. a m. beginning after the A-V valves have opened in diastole, i.e., an appreciable time after the second heart sound, as the m. of mitral stenosis.

- mill wheel m. churning cardiac m. produced by air embolism to the heart; also heard in pneumohydropericardium. SYN: water wheel m..

- mitral m. a m. produced at the mitral valve, either obstructive or regurgitant.

- musical m. a cardiac or vascular m. having a high-pitched musical character.

- nun's m. SYN: venous hum.

- obstructive m. a m. caused by narrowing of one of the valvular orifices.

- organic m. a m. caused by an organic lesion.

- pansystolic m. a m. occupying the entire systolic interval, from first to second heart sounds. SYN: holosystolic m..

- pericardial m. a friction sound, synchronous with the heart movements, heard in certain cases of pericarditis.

- pleuropericardial m. a pleural friction sound over the pericardial region, synchronous with the heart's action, and simulating a pericardial m. (rub).

- presystolic m. a m. heard at the end of ventricular diastole (during atrial systole if in sinus rhythm), usually due to obstruction at one of the atrioventricular orifices. SYN: atriosystolic m., late diastolic m..

- pulmonary m., pulmonic m. a m. produced at the pulmonary orifice of the heart, either obstructive or regurgitant.

- regurgitant m. a m. due to leakage or backward flow at one of the valvular orifices of the heart.

- respiratory m. SYN: vesicular respiration.

- Roger m. a loud pansystolic m. maximal at the left sternal border, caused by a small ventricular septal defect. SYN: bruit de Roger, Roger bruit.

- sea gull m. a m. imitating the cooing sound of a seagull nearly always due to aortic stenosis or mitral regurgitation.

- seesaw m. SYN: to-and-fro m..

- Steell m. SYN: Graham Steell m..

- stenosal m. an arterial m. due to narrowing of the vessel from pressure or organic change.

- Still m. an innocent musical m. resembling the noise produced by a twanging string; almost exclusively in young children, of uncertain origin and ultimately disappearing.

- systolic m. a m. heard during ventricular systole.

- to-and-fro m. m. heard in both systole and diastole of the heart, as in aortic stenosis and insufficiency. SYN: seesaw m..

- tricuspid m. a m. produced at the tricuspid orifice, either obstructive or regurgitant.

- vascular m. a m. originating in a blood vessel.

- venous m. a m. heard over a vein.

- vesicular m. SYN: vesicular respiration.

- water wheel m. SYN: mill wheel m..

mur·mur 'mər-mər n an atypical sound of the heart typically indicating a functional or structural abnormality called also heart murmur

a noise, heard with the aid of a stethoscope, that is generated by turbulent blood flow within the heart or blood vessels. Turbulent flow is produced by damaged valves, septal defect, narrowed arteries, or arteriovenous communications. Heart murmurs can also be heard in normal individuals, especially those who have hyperactive circulation, and frequently in normal children (innocent murmurs). Murmurs are classified as systolic or diastolic (heard in ventricular systole or diastole respectively); continuous murmurs are heard throughout systole and diastole.