The key to understanding heart murmurs is realizing that:
Systole=ventricle contracting
Diastole=atria contracting or the aortic pressure pushing back on the aortic valve
Murmurs that occur during SYSTOLE:
1. Blood going forward through a narrow aortic valve (aortic stenosis, crescendo-decrescendo)
2. Blood going forward through a ventricular septal defect (VSD, holosystolic)
3. Blood going through a narrowed aortic outflow tract (hypertrophic cardiomyopathy)
4. Blood going back through a leaky mitral valve (mitral regurgitation, holosystolic)
Murmurs that occur during DIASTOLE (remember that diastole is when the atria contract or the aorta pushes back on the aortic valve):
1. Blood going forward through a narrow mitral valve (mitral stenosis)
2. Blood being pushed back through a leaky aortic valve (aortic regurgitation)
The murmur of an atrial septal defect (ASD) is a fixed split S2.
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