Overview
A holosystolic murmur is a type of heart murmur heard throughout the entire systolic phase of the heartbeat. It is typically detected during auscultation with a stethoscope and can indicate underlying heart conditions affecting the heart valves or the heart’s structure.
Holosystolic murmurs are most commonly associated with mitral regurgitation, tricuspid regurgitation, and ventricular septal defects. In South Korea, cardiology clinics and advanced hospitals provide diagnosis, imaging, and treatment options, ranging from medication management to minimally invasive or surgical interventions.
Key Facts
🟢 ➤ A holosystolic murmur is a continuous murmur that occurs throughout systole.
🟢 ➤ Common causes include mitral regurgitation, tricuspid regurgitation, and ventricular septal defects.
🟢 ➤ The murmur is usually high-pitched, blowing, and best heard at specific areas of the chest.
🟢 ➤ Symptoms may be absent in mild cases but can include shortness of breath, fatigue, or palpitations.
🟢 ➤ Early detection and management prevent complications such as heart failure or arrhythmias.
🟢 ➤ Korea offers advanced echocardiography, cardiac catheterization, and surgical interventions for treatment.
What is a Holosystolic Murmur?
A holosystolic murmur is a heart murmur that begins with the first heart sound (S1) and continues to the second heart sound (S2) without interruption.
Key points:
➤ Occurs during systole – the phase when the heart contracts to pump blood.
➤ Blowing, uniform sound – distinguishes it from other types of murmurs that may be crescendo-decrescendo or late systolic.
➤ Location of maximum intensity helps identify the underlying cause:
- Mitral regurgitation – best heard at the apex, radiates to the axilla.
- Tricuspid regurgitation – best heard at the lower left sternal border, increases with inspiration.
- Ventricular septal defect – loudest at the left lower sternal border.
➤ Often detected during routine physical exams or when investigating shortness of breath, fatigue, or heart rhythm abnormalities.
Symptoms Related to Holosystolic Murmur
Symptoms depend on the underlying cause and severity:
🟢 ➤ Some patients may be asymptomatic, especially in mild cases.
🟢 ➤ Shortness of breath, especially during exertion.
🟢 ➤ Fatigue or reduced exercise tolerance.
🟢 ➤ Palpitations or irregular heartbeat.
🟢 ➤ Swelling in legs or abdomen if associated with heart failure.
🟢 ➤ Cyanosis (bluish lips or skin) in severe congenital cases such as large ventricular septal defects.
Causes / Possible Causes
Holosystolic murmurs arise from structural or functional abnormalities in the heart valves or septum:
Mitral Regurgitation
➤ The mitral valve does not close properly, causing blood to leak back into the left atrium.
➤ Causes: valve prolapse, rheumatic heart disease, infection (endocarditis), or ischemic heart disease.
Tricuspid Regurgitation
➤ The tricuspid valve allows blood to flow backward into the right atrium.
➤ Causes: valve damage, pulmonary hypertension, or right ventricular dilation.
Ventricular Septal Defect (VSD)
➤ A hole in the ventricular septum allows blood to flow from the left to the right ventricle.
➤ Causes: congenital heart defect, rarely acquired after myocardial infarction or trauma.
Other Causes
➤ Cardiomyopathy, previous heart surgeries, or infective endocarditis can contribute to murmurs.
When Should I See a Doctor?
Prompt medical evaluation is necessary if you notice:
🟢 ➤ Shortness of breath, fatigue, or reduced exercise capacity.
🟢 ➤ Swelling in legs, abdomen, or around the eyes.
🟢 ➤ Palpitations, dizziness, or fainting.
🟢 ➤ Cyanosis or bluish discoloration of lips or skin.
🟢 ➤ Murmurs detected during routine checkups require further investigation.
Early consultation allows accurate diagnosis, monitoring, and treatment, preventing complications such as heart failure, arrhythmias, or pulmonary hypertension.
Care and Treatment
Treatment focuses on managing the underlying cause, preventing complications, and relieving symptoms:
Medical Management
➤ Medications for heart failure or high blood pressure, such as diuretics, ACE inhibitors, or beta-blockers.
➤ Antiarrhythmic drugs for irregular heart rhythms.
Surgical or Interventional Treatments
➤ Valve repair or replacement for mitral or tricuspid regurgitation.
➤ Closure of ventricular septal defects using catheter-based techniques or open-heart surgery.
➤ Surgery is recommended based on severity, symptoms, and risk of complications.
Monitoring and Follow-up
➤ Regular echocardiography and cardiac evaluations to monitor murmur progression.
➤ Lifestyle modifications including exercise as tolerated, balanced diet, and avoiding smoking.
Advanced Care in Korea
➤ Korean cardiology centers offer state-of-the-art imaging, minimally invasive cardiac procedures, and expert surgical care.
➤ Multidisciplinary teams ensure safe and effective treatment plans for children and adults.
Highlights (Clean Green Arrow Version)
🟢 ➤ Holosystolic murmur is a continuous murmur throughout systole, indicating heart valve or septal problems.
🟢 ➤ Common causes: mitral regurgitation, tricuspid regurgitation, and ventricular septal defects.
🟢 ➤ Symptoms: shortness of breath, fatigue, palpitations, swelling, cyanosis, or sometimes asymptomatic.
🟢 ➤ Diagnosis requires auscultation, echocardiography, and sometimes cardiac catheterization.
🟢 ➤ Treatment: medications, valve repair/replacement, VSD closure, and lifestyle modifications.
🟢 ➤ South Korea provides advanced cardiology care, imaging, minimally invasive procedures, and expert surgical interventions.
