Murmurs are characterized by their grade, pitch, timing in the cardiac cycle, change in intensity, quality, location heard best, and radiation. Systolic murmurs. Almost all systolic murmurs begin in ...

The Means-Lerman scratch is a mid-systolic murmur heard in the setting of a hyperthyroid state at the left upper sternal border and end-expiration. This is thought to occur from rubbing of the ...