Guidelines on auscultation of murmurs for heart testing schemes

   Minimise

The follow guidelines are recommended for the purpose of the heart testing schemes.

Methods of heart testing

  1. Consistency in the grading of heart murmurs is important between cardiologists. The follow guidelines are recommended for the purpose of the heart testing schemes.
    • Grade 2/6 is less intense than the heart sounds
    • Grade 3/6 is of a similar intensity to the heart sounds
    • Grade 4/6 is more intense than the adjacent heart sounds.

  2. Where the Point of Maximal Intensity of a murmur is found to be very localised, but with a lower grade of murmur also audible elsewhere, the grade of the localised murmur should be recorded.

  3. When murmurs vary markedly with respirations and/or sinus arrhythmia, the mean or modal grade should be allocated, rather than the maximum (eg. often found in the first beat or a series).

  4. Where a decision between two grades is not easily made: to help to differentiate between the grades, the higher grade should be recorded where there is a marked radiation of the murmur and/or where the murmur is more than of brief duration.