225
4754147819011156112
other.851596012870110179242289324
The1217596012885155218
pendulum-like1470596012876138209278348387457567614653692762825
rhythm2330596012853122193230301410
resembles2774596012854116171234343411450513568
the3377596012846116178
sound3590596012862132202272341
of3967596012877124
a4126596012869
swinging4230596012862164202272342381450521
pendulum.4787596012877138209278348387457567599
If5421596012854100
the851839012839110172
pendulum-like10598390128150212282351422460530640685724764834897
rhythm19918390128127197268305376485
is25098390128120176
accompanied27218390128143206268337447515578648687750819
by35768390128150221
tachycardia,38308390128120183245315386447509556626665726761
this46278390128119190228283
indicates49458390128120190261299362424462525578
embryocardia,8511080012862173241288358426489551598668708770805
resembling16911080012846109163226335403443481552621
the23481080012837108171
heartbeat25521080012871133196241280350413475513
of31001080012871117
a32521080012862
fetus.33491080012846109148218273308
Auscultation120513260126101179233296374413461530577615684763
of20031326012670117
Heart215513260126109170240302349
Murmurs.253913260126133210272389466528583619
Heart120515630128101163225272311
murmurs155215630128135203250360428475530
are21181563012888135197
sounds23501563012881150221291360415
often28011563012895142181244313
occurring31491563012897158221290337384423492562
in37471563012865134
the39171563012865135197
pathology41491563012896159197268337376446516587
of47691563012896143
the49471563012865136199
heart,51811563012895158220267305340
distinguished8511805012870110164203242311382452490545615677747
from16331805012887134204314
heart198018050128111174236283321
sounds23371805012895164235305374429
by280218050128109180
their30151805012879150213251298
longer33481805012879149220289352399
duration.378218050128109180226289328366436506542
The436318050128125195258
mechanism465618050128150209272342405475515569678
of536718050128111158
murmur85120460128109177224335402450
formation13362046012887157204314374413452523593
is19642046012878132
associated213220460128102156211280343381444482544614
with278120460128142180219288
the31052046012878149210
transition33512046012879126187258312351390428499568
of395520460128109156
laminar41452046012880141251287359422469
blood464920460128109148218288358
flow50422046012887125195297
to53732046012878148
turbulent.8512288012839110157226296335397467505541
Causes12052529012894156226280343398
of16372529012870117
Heart178925290128102163225272310
Murmurs.213525290128125193240348416463518555
1.12052771012870106
Morphological134627710128196266314383453523561632702740803865903
(anatomical22852771012865128198260299368478515577640679
changes29992771012882152215284353416471
in35052771012857127
the36672771012858128189
structure38922771012873112160229291329400446508
of44362771012889136
the46072771012856127189
heart,48312771012889152213260299334
valve52002771012889152190259322
apparatus,8513012012862133202265312374412483537572
and14583012012862132202
vessels):16943012012870133188242304342396443483
•12053254012849
stenosis128932540128183222285354424479517572
(narrowing)18973254012847116178225271341443480551620667
of25983254012870118
valve27513254012871133172242305
openings;30913254012870139202271309380450504544
•12053495012849
insufficiency128934950128167238292362409456495556596658727790860
of21833495012881129
valves23473495012882143182252314368
–27513495012883
when288234950128101169232301
the32193495012850120183
valve34373495012880143182252315
does37873495012880151213267
not40903495012881151190
completely43153495012874143253321360423462525562633
cover49813495012875146215278325
the53413495012851120182
valve8513737012870133172242304
opening;11893737012870141203273311381452491
•12053979012849
congenital128939790128191261331401464533572611674712
defects20363979012896159206268331369423
in24943979012866136
the26643979012867137200
heart28993979012896159221267306
structure32403979012881121168237300337407454517
–379239790128100
often39273979012898145183246315
atrial42773979012890128175214276315
and46273979012890159228
ventricular48913979012897159229269315354417486524587634
septal8514220012855117188226289327
defects.12134220012870132179241303341396432
2.12054461012870106
Hemodynamic134644610128173235345413483554622685795832895
factors22764461012876139201239310357410
(presence27224461012876145192255308371441503565
of33224461012899146
a35034461012892
large36294461012869132177247309
pressure39734461012899146208262317387434496
gradient450344610128100147208279317380449488
between50314461012899162200302364426495
heart8514702012870133195242280
chambers11674702012862131194303371433480535
or17374702012871117
the18894702012838109171
heart20944702012870132195242279
chamber24094702012862133194303371434481
and29254702012862132203
a31634702012863
vessel).32594702012870133188242304342389425
3.12054945012870106
Rheological134649450128165235298367407476546585648709748
factors21304945012847109170209278326379
–25454945012871
decreased26504945012870133195242304367421483552
blood32384945012870108178249318
viscosity,35904945012870110164227296351389429499533
as41584945012861116
seen43104945012854117179248
in45944945012839108
anemia.47384945012862131194303341403439
Classification12055186012894133195249304342390429490553592630700771
of20095186012871118
Murmurs:216251860128125194241349417464518558
1.12055427012870106
By134654270128165235
location:16155427012839109172234273312382452491
intracardiac,21425427012837108146194256317380426495534597659694
extracardiac,28715427012862131171218280341404451520559621683718
vascular.36245427012870133187248318358420467502
2.12055669012870106
By134656690128165235
the16155669012839110173
cause18235669012863125195251312
of21715669012871118
formation,23245669012847118164273334373413482552588
intracardiac29475669012839110148195258319381428497537599661
murmurs364656690128110177226336404451506
are41875669012863110172
divided43945669012872110180219289352421
into48505669012840110149219
organic51045669012871118187250319359420
and8515911012862133202
functional.10895911012846117186249287326396465528567603
3.12056152012870106
By134661520128165235
the16156152012839109172
mechanism182361520128109169231301364435473528638
of24936152012871117
formation26456152012847117165274334373412483553
–32336152012872
stenotic,3341615201285392155224294333372434469
regurgitant.38446152012847109179249296366405444506576615650
4.12056393012870106
By134663930128165235
relation16156393012846109148210249289358429
to20806393012837108
the22236393012838108170
phases24286393012870140202256319373
of28356393012871118
the29886393012839108171
cardiac31946393012862123170240279342404
cycle36336393012863133193232295
–39636393012873
systolic40716393012854124177216287325365427
and45336393012862132202
diastolic.47706393012870109171225264334373412475510
5.12056635012870106
By134666350128165235
the16156635012855126188
timing1838663501285695205242312383
of22566635012886133
occurrence24246635012885148211280327374436505568630
in30896635012855125
systole32506635012870140193232303341404
or36896635012886133
diastole:38566635012886126189242282351390453490
proto-,43826635012887134203242312365400
mid-,483366350128109146217264300
mesosystolic5185663501281091692242948516877012855125178217288327366429
(-diastolic),1315687701284793163201264318357427466505567614649
pansystolic19986877012870132202257328380420490528567630
(-diastolic).2663687701284795164203265319358428467506569615649
6.12057118012870106
By134671180128165235
shape161571180128128199262332395
–204571180128144
crescendo,222471180128137184246300362424494563634670
decrescendo,292971180128142205267314376430493555624694765800
diamond-shaped3763711801281441832463554234945636136687378008699321001
(crescendodecrescendo),4800711801281201822282913454084695406096798517360012870133195242304358421483552622692739774
and16607360012862132201
decrescendo-crescendo1897736001287013219324030235741948155162169073980184891096410261089115812281298
(Fig.15.).32317360012846124163232268338407443490525