Holosystolic Murmur Introduction

A holosystolic murmur begins immediately after the first heart sound (S1) and continues to just before the second heart sound (S2), as illustrated in the phonocardiogram. Typically high-pitched, these murmurs are usually caused by ventricular septal defect, mitral regurgitation or tricuspid regurgitation, as discussed below. This murmur is also called a pansystolic murmur.

Auscultation Position

Holosystolic murmurs are usually best heard at the apex or lower left sternal border.

holosystolic murmur

Ventricular Septal Defect

Ventricular Septal Defect (VSD) is a congenital condition associated with abnormal blood flow between the left ventricle and the right ventricle due to a shunt (hole) in the wall that separates the right and left ventricles. Holosystolic murmurs can be auscultated over the left 3rd and 4th intercostal spaces and along the sternal border.

Our reference guide for a holosystolic murmur caused by ventricular septal defect: Ventricular Septal Defect Lesson


Audio Playback

virtual auscultation of patient torso

auscultation position of patient

The patient's position is supine.


Heart Sounds Reference Guide

Our auscultation reference guide provides quick access to this sound as well as many other adventitious sounds. Each sound is described also with an audio recording and waveform.

Authors and Reviewers

Authored by Dr. Barbara A Erickson., W. Proctor Harvey, MD
Medically reviewed by Dr. Jonathan Keroes, MD, Cardiology

Authors and Reviewers


Systolic Murmurs - Dorland's Medical Dictionary
? v:1 | onAr:0 | onPs:2 | tLb:1 | tLbJs:0
isPageNeedsInvoke:False | isTc: False | cc:
isHome:False | uStat: False | db:0 | pu:False | jsNext:False | pv:1 | refreshTime: 1/1/0001 12:00:00 AM || now: 5/25/2024 4:32:30 PM

An error has occurred. Please reload the page or visit our other website, Practical Clinical Skills. Reload 🗙