Differentiating between pathologic and innocent (physiologic or functional) murmurs is high yield for the USMLE exam.
Here's a list of features that distinguishes the pathologic murmur:
Here's a list of features that distinguishes the pathologic murmur:
- Murmur intensity or quality unchanged with change of position
- Presence of symptoms such as dyspnea, chest pain, syncope
- Presence of abnormal S2
- Any pansystolic murmur
- Any diastolic murmur (note that murmur throughout systole and diastole can still be physiologic)
- Any murmur with grade equal to or over III/VI
- Presence of palpable thrill