These murmurs are continuous throughout systole and diastole. It is due to continuous blood flow in the same direction in both systole and diastole unlike a to and fro murmur in which blood flows in one direction in systole and in opposite direction in diastole.
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| Coetinuous |
Characteristic: High pitch continuous "Machinery ' lnurnlur best heard in the second left intercostal space with radiation to chest, neck and back. It typically begins after S1, gradually increases in intensity, peaks at or immediately after S2 and gradually fades to a variable duration in diastole depending oil pulmonary arlery pressure; the higher the pressure lesser the duration of nwrnlur in diastole.There are some additional clicking sounds in late systole and in early diastole,called Eddy sounds are veiy characteristic of a continuous murmur caused by
If the next loudest sound is not heard in the first left interspace but heard in the third left interspace the diagnosis of PDA should not be entertained and the other causes of continuous murmur such as coronaiy artery cai~leral fistula into RA/RV or Ruptured Sinus of Valsalva should be kept in mind.
ti)Venous Hum
Characteristic: Col~tinuous sound with diastolic component often a h~glicr pitched and louder than the systolic, best heard just above the clavicle, lllore likely on the right side (right Jugular vein larger than the left). It is best heard with the bell of the stethoscope with the patient sitting up with his or her feet on the bed and his head turned away maximally with raised chin. It disappears on con~pressing jugular vein. It is most common type of noimal continuous murmur and often heard in healthy children.
iii) Arteriovenous Continuous Murmur
These can be coilgenital as in coronaly astev !istula entering RA/RV/PA, sinus of valsalva to right side of heart cominunication and ALCAPA or it can be acquired as in surgically created AV fistulas.
iv) Arterial Continuous Murmurs
These originate in constricted arteries as in carotid or femoral artery obsti-uction (Mumurs are louder in systole, often only systolic) or in non-constricted arteries as in patients with large systemic lo pulmonary arterial collaterals in TOF with pulmonary atresia. Mammary soufflk is an innocent murmur heard durtrllb late pregnancy and puerperiunl. It is typically louder in systole.
ti)Venous Hum
Characteristic: Col~tinuous sound with diastolic component often a h~glicr pitched and louder than the systolic, best heard just above the clavicle, lllore likely on the right side (right Jugular vein larger than the left). It is best heard with the bell of the stethoscope with the patient sitting up with his or her feet on the bed and his head turned away maximally with raised chin. It disappears on con~pressing jugular vein. It is most common type of noimal continuous murmur and often heard in healthy children.
iii) Arteriovenous Continuous Murmur
These can be coilgenital as in coronaly astev !istula entering RA/RV/PA, sinus of valsalva to right side of heart cominunication and ALCAPA or it can be acquired as in surgically created AV fistulas.
iv) Arterial Continuous Murmurs
These originate in constricted arteries as in carotid or femoral artery obsti-uction (Mumurs are louder in systole, often only systolic) or in non-constricted arteries as in patients with large systemic lo pulmonary arterial collaterals in TOF with pulmonary atresia. Mammary soufflk is an innocent murmur heard durtrllb late pregnancy and puerperiunl. It is typically louder in systole.
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