66:
The Levine scaling system persists as the gold standard for grading heart murmur intensity. It provides accuracy, consistency, and interrater agreement which are essential for diagnostic purposes, particularly to distinguish
233:
39:
who studied the significance of systolic heart murmurs. The grading gives a number to the intensity from 1 to 6: The palpable murmur is known as thrill, which can be felt on grade 4 or higher.
226:
219:
71:
from pathological murmurs. Louder murmurs (grade ≥3) are more likely believed to represent cardiac defects that tend to have hemodynamic consequences.
113:
94:
Silverman ME, Wooley CF. Samuel A. Levine and the history of grading systolic murmurs. Am J Cardiol. 2008 Oct 15;102(8):1107-10.
59:
A loud murmur with a thrill. The murmur is so loud that it is audible with only the rim of the stethoscope touching the chest.
129:
Freeman AR, Levine SA (1933). "Clinical significance of systolic murmurs: Study of 1000 consecutive "noncardiac" cases".
656:
820:
861:
62:
A loud murmur with a thrill. The murmur is audible with the stethoscope not touching the chest but lifted just off it.
628:
384:
156:
484:
346:
894:
709:
547:
341:
814:
324:
211:
840:
747:
651:
556:
369:
351:
899:
867:
696:
584:
569:
508:
363:
579:
855:
788:
766:
760:
531:
375:
358:
307:
246:
242:
850:
574:
171:
647:
521:
516:
439:
334:
329:
302:
109:
68:
752:
723:
564:
479:
451:
444:
429:
272:
183:
138:
36:
17:
741:
685:
678:
808:
780:
661:
623:
589:
619:
614:
537:
489:
75:
888:
845:
801:
774:
399:
312:
262:
690:
609:
467:
319:
292:
284:
28:
202:
638:
600:
526:
424:
419:
389:
142:
47:
188:
27:
is a numeric scoring system to characterize the intensity or the loudness of a
496:
254:
472:
795:
297:
732:
702:
267:
32:
108:(4th ed.). Philadelphia: Wolters Kluwers Health. p. 339.
74:
The Levine scale is usually written down as a fraction of 6 and in
411:
394:
172:"Evaluation of a Novel Method for Grading Heart Murmur Intensity"
157:"Medline Plus Medical Dictionary, definition of "cardiac thrill""
832:
43:
The murmur is only audible on listening carefully for some time.
215:
205:. Lippincott Williams & Wilkins, Oct 1, 2004; page 106.
46:
The murmur is faint but immediately audible on placing the
831:
731:
722:
670:
637:
598:
555:
546:
507:
460:
410:
283:
253:
170:Keren Ron; Tereschuk Michele; Luan Xianqun (2005).
53:A loud murmur readily audible but with no thrill.
106:Sapira's Art & Science of Bedside Diagnosis
227:
8:
203:Heart Sounds Made Incredibly Easy!, Volume 1
104:Orient JM (2010). "Chapter 17: The Heart".
728:
552:
234:
220:
212:
187:
87:
7:
14:
1:
56:A loud murmur with a thrill.
862:superior vena cava syndrome
143:10.7326/0003-4819-6-11-1371
23:In cardiac physiology, the
916:
189:10.1001/archpedi.159.4.329
78:, as in a scale of II/VI.
15:
775:radial artery sufficiency
385:Pericardial friction rub
176:Arch Pediatr Adolesc Med
16:Not to be confused with
821:Nicoladoni–Branham sign
485:Jugular venous pressure
347:Pulmonary insufficiency
710:Gallavardin phenomenon
548:Cardiovascular disease
815:arteriovenous fistula
629:Bracht–Wachter bodies
652:Pericardial effusion
557:Aortic insufficiency
370:Mitral insufficiency
352:Graham Steell murmur
25:Levine grading scale
585:Austin Flint murmur
364:Carey Coombs murmur
35:is from researcher
856:Trendelenburg test
789:pseudohypertension
767:Right heart strain
761:pulmonary embolism
376:Presystolic murmur
247:circulatory system
243:Signs and symptoms
882:
881:
878:
877:
841:Friedreich's sign
748:Cardarelli's sign
718:
717:
648:Cardiac tamponade
440:Pulsus bisferiens
330:Functional murmur
115:978-1-60547-411-3
907:
868:Pemberton's sign
729:
724:Vascular disease
570:De Musset's sign
565:Collapsing pulse
553:
452:Pulsus alternans
445:Pulsus bigeminus
430:Pulsus paradoxus
245:relating to the
236:
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37:Samuel A. Levine
915:
914:
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906:
905:
904:
885:
884:
883:
874:
851:Kussmaul's sign
827:
742:aortic aneurysm
714:
686:Anitschkow cell
679:rheumatic fever
666:
633:
594:
575:Duroziez's sign
542:
503:
456:
406:
279:
249:
240:
210:
209:
201:
197:
169:
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155:
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128:
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116:
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98:
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84:
21:
12:
11:
5:
913:
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902:
897:
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871:
870:
858:
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848:
843:
837:
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829:
828:
826:
825:
824:
823:
811:
806:
805:
804:
792:
785:
784:
783:
771:
770:
769:
757:
756:
755:
750:
737:
735:
726:
720:
719:
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713:
712:
707:
706:
705:
693:
688:
683:
674:
672:
668:
667:
665:
664:
659:
643:
641:
635:
634:
632:
631:
626:
620:Janeway lesion
617:
605:
603:
596:
595:
593:
592:
587:
582:
577:
572:
567:
561:
559:
550:
544:
543:
541:
540:
538:Template:Shock
534:
529:
524:
519:
513:
511:
505:
504:
502:
501:
499:
494:
493:
492:
490:Cannon A waves
482:
477:
476:
475:
464:
462:
458:
457:
455:
454:
449:
448:
447:
442:
432:
427:
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416:
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408:
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404:
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402:
392:
387:
382:
381:
380:
379:
378:
366:
361:
356:
355:
354:
349:
339:
338:
337:
335:Still's murmur
332:
317:
316:
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310:
305:
300:
289:
287:
281:
280:
278:
277:
276:
275:
265:
259:
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241:
239:
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231:
224:
216:
208:
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195:
182:(4): 329–334.
162:
148:
131:Ann Intern Med
121:
114:
96:
86:
85:
83:
80:
76:Roman numerals
64:
63:
60:
57:
54:
51:
44:
13:
10:
9:
6:
4:
3:
2:
912:
901:
898:
896:
895:Heart murmurs
893:
892:
890:
869:
866:
865:
864:
863:
859:
857:
854:
852:
849:
847:
846:Caput medusae
844:
842:
839:
838:
836:
834:
830:
822:
819:
818:
817:
816:
812:
810:
807:
803:
802:Lines of Zahn
800:
799:
798:
797:
793:
791:
790:
786:
782:
779:
778:
777:
776:
772:
768:
765:
764:
763:
762:
758:
754:
753:Oliver's sign
751:
749:
746:
745:
744:
743:
739:
738:
736:
734:
730:
727:
725:
721:
711:
708:
704:
701:
700:
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698:
694:
692:
689:
687:
684:
682:
680:
676:
675:
673:
669:
663:
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658:
655:
653:
649:
645:
644:
642:
640:
636:
630:
627:
625:
621:
618:
616:
613:
611:
607:
606:
604:
602:
597:
591:
588:
586:
583:
581:
580:MĂĽller's sign
578:
576:
573:
571:
568:
566:
563:
562:
560:
558:
554:
551:
549:
545:
539:
535:
533:
530:
528:
525:
523:
520:
518:
515:
514:
512:
510:
506:
500:
498:
495:
491:
488:
487:
486:
483:
481:
480:CĹ“ur en sabot
478:
474:
471:
470:
469:
466:
465:
463:
459:
453:
450:
446:
443:
441:
438:
437:
436:
433:
431:
428:
426:
423:
421:
418:
417:
415:
413:
409:
401:
398:
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391:
388:
386:
383:
377:
374:
373:
372:
371:
367:
365:
362:
360:
357:
353:
350:
348:
345:
344:
343:
340:
336:
333:
331:
328:
327:
326:
323:
322:
321:
318:
314:
313:Gallop rhythm
311:
309:
306:
304:
301:
299:
296:
295:
294:
291:
290:
288:
286:
282:
274:
273:Levine's sign
271:
270:
269:
266:
264:
263:Referred pain
261:
260:
258:
256:
252:
248:
244:
237:
232:
230:
225:
223:
218:
217:
214:
204:
199:
196:
190:
185:
181:
177:
173:
166:
163:
158:
152:
149:
144:
140:
137:: 1371–1379.
136:
132:
125:
122:
117:
111:
107:
100:
97:
91:
88:
81:
79:
77:
72:
70:
61:
58:
55:
52:
50:on the chest.
49:
45:
42:
41:
40:
38:
34:
30:
26:
19:
18:Levine's sign
860:
813:
809:Adson's sign
794:
787:
781:Allen's test
773:
759:
740:
695:
691:Aschoff body
677:
662:Ewart's sign
657:Beck's triad
646:
624:Osler's node
610:endocarditis
608:
590:Mayne's sign
536:See further
532:Distributive
468:Palpitations
434:
368:
320:Heart murmur
293:Heart sounds
285:Auscultation
198:
179:
175:
165:
151:
134:
130:
124:
105:
99:
90:
73:
65:
29:heart murmur
24:
22:
639:Pericardium
615:Roth's spot
601:endocardium
527:Hypovolemic
522:Obstructive
517:Cardiogenic
425:Bradycardia
420:Tachycardia
390:Heart click
48:stethoscope
900:Turbulence
889:Categories
497:Hyperaemia
359:Continuous
255:Chest pain
82:References
473:Apex beat
342:Diastolic
796:thrombus
733:Arterial
325:Systolic
298:Split S2
69:innocent
435:doubled
400:carotid
833:Venous
703:J wave
599:Other
268:Angina
112:
33:eponym
31:. The
671:Other
509:Shock
461:Other
412:Pulse
395:Bruit
110:ISBN
697:EKG
184:doi
180:159
139:doi
891::
308:S4
303:S3
178:.
174:.
133:.
681::
654::
650:/
622:/
612::
235:e
228:t
221:v
192:.
186::
159:.
145:.
141::
135:6
118:.
20:.
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