Important Murmurs for USMLE Step 1

Systole Diastole
(between S1 and S2) (after S2, before S1)
Mitral Regurgitation Holosystolic, high-pitched
murmur
Aortic Stenosis Mid to Late systolic ejection
murmur, crescendo-decrescendo
VSD Holosystolic murmur

Mitral Valve Prolapse Mid-systolic click

Aortic Regurgitation Early diastolic blowing murmur

Mitral Stenosis Opening snap, mid diastolic

rumbling murmur
PDA Continuous machine like murmur Continuous machine like murmur

Pulmonic Stenosis Systolic ejection murmur

Tricuspid Stenosis Late diastolic rumbling murmur,

get louder with inspiration
ASD Systolic murmur, wide, fixed, split
S2

 S3 – volume overload
 S4 – pressure overload