Grading the Intensity of a Cardiac Murmur

Features

Grade

no murmur

0

barely audible with effort, requiring an extremely quiet examining room

1

soft but easily heard

2

loud without a palpable thrill or sound

3

loud with a palpable thrill or sound

4

loud enough to be heard with the stethoscope only partially or barely in contact with the chest wall

5

loud enough to be heard with the stethoscope not in contact with the chest wall

6

Loudness

Palpable Sign

Stethoscope

Grade

none

absent

full contact

0

barely audible

absent

full contact

1

soft

absent

full contact

2

loud

absent

full contact

3

loud to very loud

present

full contact

4

very loud

present

partial

5

very loud

present

none

6