Cardiology Murmurs

Pulmonic Stenosis

Pulmonic stenosis is virtually always congenital. However, it may occur as a result of acquired conditions such as rheumatic disease and carcinoid syndrome.
The systolic murmur of pulmonic stenosis is best heard over the left upper sternal border, is crescendo-decrescendo in shape, and radiates to the neck, left shoulder, and back.
With increasing severity, the murmur peaks later and lasts longer.

Patient 1

This is a young woman with Alagille syndrome complicated by pulmonic stenosis. Note the increase in intensity of the murmur with inspiration.

Pulmonic Stenosis

Annotated