MURMURS made Easy*

*Slightly Easier…

Mnemonic: hARD ASS MRS. MSD

AR(d) - diastolic
AS(s) - systolic
MR(s) - systolic
MS(d) - diastolic
Aortic/Pulmonary go together
Mitral/Tricuspid go together

According to this, AS and MR are Systolic

We know that for Systolic murmurs, there is something called Ejection systolic,
and there is something called PAN-systolic
Now we just have to match them:

We know AS is always Ejection systolic

(cuz the ventricle pumps out w/shear force in the beginning of systole)
 and since Pul = Aortic : PS is also Ejection systolic

So, that means MR must be PAN-systolic

 and since Mitral =Tricuspid : TR is also PAN-systolic
 BUT WAIT! PAN is three letters, so there must be another murmur that is also PAN
 and that murmur is VSD = PAN-systolic
(cuz VSD means the ventricles are acting as a single chamber. Thus, throughout the
entire ventricular contraction (systole), there is always blood being squeezed through
the VSD)

According to the mnemonic, AR and MS are Diastolic

and they appear as the first and last murmurs in the mnemonic, respectively
We know that for Diastolic there is something called Early Diastolic and (mid to-)Late
Diastolic
Yahya Firoze, MBBS
Since AR comes first in the mnemonic, it is Early diastolic
since MS comes last in the mnemonic it is Late diastolic
 and since Aortic = Pul : PR is also Early Diastolic
 and since Mitral = Tricuspid : TS is also Late Diastolic

PDA : if u don't know it is a machinery-like murmur occurring throughout both systole

and diastole, please don't take the exam

Extra Information:

MSD (M.S.Dhoni) Runs Fast  Mitral Stenosis is mostly seen in Rheumatic Fever

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The intensity of ALL murmurs increases with increase in Venous Return (except HCM &
MVP)

Mnemonic: V Stand for HCM and MVP

 Valsalva and Standing increase the intensity of HCM and MVP murmurs

[Squatting is the opp. of Standing; so, if a murmur ↑ with standing = ↓ with squatting]

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VSD causes a PAN-systolic murmur with a THRILL. The smaller the hole, the more
intense the thrill

Yahya Firoze, MBBS

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Remember MR and MVP together (both cause Systolic murmurs). MVP also stands for
most valuable player, and so, always associate good things with Mitral Valve Prolapse.
Thus, think of the MVP of a team (i.e. a tall athlete)  Conn Tissue Disorders [Marfans,
Ehlers–Danlos, etc.]. Think of good things such as ASYMPTOMATIC and No Treatment
Required (well, except for minor things such as Beta Blockers for Palpitations

Yahya Firoze, MBBS