fig5

Figure 5. Murmurs which start in systole and spill into diastole, are named continuous murmurs (top). The murmur starts during the systole, has a crescendo character until it reaches the 2nd heart sound (S₂). Then, the murmur decrescendos to a variable time through the diastole. In contradistinction, a to-and-fro murmur (bottom) is composed of two separate murmurs: (1) an ejection systolic murmur; and (2) early diastolic decrescendo murmur. A distinct space between the ejection murmur and S₂ is present. Modified from Rao^[5].