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Table 17-2

Gradations of Systolic Murmurs

GradeDescription
Grade 1/6Softer in volume than S1 and S2, very faint
Grade 2/6Equal in volume to S1 and S2, quiet, but heard immediately
Grade 3/6Louder in volume than S1 and S2, moderately loud
Grade 4/6Louder in volume than S1 and S2, with palpable thrill
Grade 5/6Louder in volume than S1 and S2, with thrill; may be heard when the stethoscope is partly off the chest
Grade 6/6Louder in volume than S1 and S2, with thrill; may be heard with stethoscope entirely off the chest
Reprinted with permission from Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bates' guide to physical examination and history taking (13th ed., Box 16-14). Wolters Kluwer.