Murmur Description Proposed etiology Common age prevalence Audio
Still’s murmur Systolic
Grade 1 to 2
Low frequency, such as a twanging string, musical
Heard between sternal border (mid to lower position) and apex
Most common murmur in children
Unknown, theories include resonant phenomena of blood movement into the aorta, or movement across a chordae tendinae 3 to 6 years, should disappear by adolescence Audio file
Pulmonary ejection/flow murmur Systolic
Slightly grading in contrast to vibratory
Heard over left upper sternal border, no significant radiation
Exaggeration of normal ejection vibration within the pulmonary vasculature 5 to 14 years, most common in adolescents Audio file
Venous hum Continuous, diastolic portion subtly louder
Grade 1 to 2
Best heard infraclavicular and supraclavicular
Only audible when patient is upright
Can dissipate or exacerbate by head movements or obstruction of the ipsilateral jugular veins
Vibration of the veins carrying the blood from the head and upper body to the superior vena cava 3 to 6 years Audio file