What murmur is heard in Ventricular Septal Defect (VSD)?
Harsh pansystolic (holosystolic) murmur at LLSB, may have a thrill.
What murmur is heard in Atrial Septal Defect (ASD)?
Ejection systolic murmur at ULSB with fixed wide split S2.
What murmur is heard in Patent Ductus Arteriosus (PDA)?
Continuous “machinery” murmur at left infraclavicular area with bounding pulses.
What murmur is heard in Pulmonary Stenosis?
Ejection systolic murmur at ULSB with delayed/soft P2.
What murmur is heard in Aortic Stenosis?
Ejection systolic (crescendo-decrescendo) at RUSB, radiating to carotids.
What murmur is heard in Coarctation of the Aorta?
Systolic murmur best heard over back (interscapular area) with radio-femoral delay.
What murmur is heard in Tetralogy of Fallot (TOF)?
Harsh systolic murmur (from pulmonary stenosis) at ULSB with single S2.
What murmur is heard in Transposition of Great Arteries (TGA)?
Often no murmur, single loud S2.
What murmur is heard in Tricuspid Atresia?
Pansystolic VSD murmur ± single S2.
What murmur is heard in Truncus Arteriosus?
Single S2 with a systolic murmur.
What murmur is heard in Atrioventricular Septal Defect (AVSD)?
Pansystolic murmur ± mid-diastolic murmur.
What are the main differentials for an Ejection Systolic Murmur?
Pulmonary Stenosis (ULSB, delayed/soft P2), Aortic Stenosis (RUSB, radiates to carotids, crescendo-decrescendo), Atrial Septal Defect (ULSB, fixed wide split S2), Physiological/Innocent Murmur (soft, grade I–II, no thrill).
What are the main differentials for a Pansystolic / Holosystolic Murmur?
Ventricular Septal Defect (LLSB, harsh, ± thrill), Atrioventricular Septal Defect (LLSB, may have mid-diastolic component), Mitral Regurgitation (apex, radiates to axilla), Tricuspid Regurgitation (lower LSB, increases with inspiration).
What is the differential for a Continuous (Machinery) Murmur?
Patent Ductus Arteriosus (left infraclavicular area, bounding pulses).
What are the main differentials for a Mid-Diastolic / Rumbling Murmur?
Mitral Stenosis (apex, opening snap), Tricuspid Stenosis (LLSB, increases with inspiration), Large VSD with increased flow (may have diastolic component).
What are the main differentials for a Single S2?
Severe Pulmonary Hypertension (loud P2), Pulmonary Atresia/Truncus Arteriosus (only one valve closes), TGA/Malpositioned great arteries (simultaneous closure), Severe Aortic Stenosis (soft/delayed A2).
What are the main differentials for a Widely Split S2?
ASD/PAPVR (increased RV flow → delayed P2), Pulmonary Stenosis (prolonged RV ejection), RBBB (electrical delay), Severe Mitral Regurgitation (early A2).
What are the main differentials for a Paradoxically Split S2?
Severe Aortic Stenosis (delayed LV ejection → A2 after P2), LBBB (electrical delay of LV contraction).
