The most fundamental distinction is between systolic ejection murmurs and pansystolic murmurs
2.
Pansystolic murmurs begin with s1 , extend throughout systole , and are characteristically uniform in intensity systolic ejection murmurs have been likened to the chug of a steam engine laboring up a hill , while pansystolic murmurs have been likened to the high - pitched wail of the engine ' s whistle
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