CV Block - Murmur on exertion??

[Deanis]

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So in PBL someone in my group mentioned an exertional murmur, that was apparently benign/innocent. I looked around a bit and can't seem to find anything on a murmur that is there only upon exertion. Anyone know about these? Are they typically innocent, can they be pathological? Are they typically systolic? Are these what some people call 'flow' murmurs?

Thanks.

 

[Guile]

A flow murmur refers to a benign crescendo-decrescendo systolic ejection murmur. Pregnant patients will often have these. There is no pathology per se associated with these murmurs.

I think by exertion you are referring to a murmur that gets louder on Valsalva. The prototypical murmur that worsens on Valsalva is HOCM. Other murmurs can also get louder/softer with squatting, hand grip, leaning forward, et al. It would be a good exercise to compile a list of how these maneuvers affect the murmur.