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How to decide 3

  • Presence or absence of a murmur, AND

    • Abnormal .

    • A fixed split second sound is indicative of an atrial septal defect or some other form of shunting at atrial level.

    • A loud and single second sound indicates pulmonary hypertension.

    • Clicks in association with murmurs may indicate pulmonary or aortic stenosis or mitral valve prolapse.

    • Murmurs that are loud, harsh or diastolic are never physiological.

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