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HEART MURMURS, V/VI: very loud, audible with the stethoscope edge, image,…

- - - - systolic ejection
    - - holosystoli pansystolic
  - - - II/VI: soft but easily audible
        
        I/VI: very faint, heard only with careful listening
        
        III/VI: moderately loud, no thrill
      - IV/VI: loud with a palpable thrill
- - - - TEE, cardiac MRI, or cardiac catheterization
- - - - Valve repair or replacement
    - - Serial echocardiography according to guideline recommendations
    - - Heart failure management
        
        ACE inhibitors/ARBs
        
        diuretics
        
        beta-blockers
    - - Targeted antibiotic therapy
      - Surgery when indicated