You are currently viewing Holosystolic Murmurs – Mnemonic

Here is a quick mnemonic “ATRIAL PRESSURE to remember about Holosystolic Murmurs

This can be valuable for patients as well as medical doctors, nurses & students doing their clinical rounds. You can also find it very useful for med exams like USMLE, NExT Medical Step 1&2, MBBS, NEET PG, INI-CET, FMGE,MCAT & NCLEX exams

Holosystolic Murmurs : How To Remember Easily ?

·        A – Apical holosystolic murmur is indicative of chronic MR.

·        T – TTE (Transthoracic Echocardiogram) is warranted for further characterization.

·        R – Rheumatic scarring and mitral annular calcification are associated with chronic MR.

·        I – Increase in left atrial pressure is small in chronic MR.

·        A – Apical displacement of the papillary muscles worsens the severity of MR.

·        L – Left atrial compliance is normal or increased in chronic MR.

·        P – Postinfarction left ventricular remodeling is associated with an apical holosystolic murmur.

·        R – Right ventricular dilation can result in secondary TR.

·        E – Ebstein’s anomaly is a cause of primary TR.

·        S – Severity of MR can lead to left ventricular apex displacement and diastolic filling complex.

·        S – Softer holosystolic murmur is generally heard in chronic TR.

·        U – Use Carvallo’s sign to identify TR (increase in intensity with inspiration).

·        R – Right ventricular remodeling can lead to secondary TR.

·        E – Enlargement of jugular venous waveforms is seen in the absence of an audible TR murmur.


Dr. Arin Nandi

Passionate About Medical Science & Helping Future Doctors Achieve Top Ranks In Medical Exams. He is professionally a dentist as well as a public health expert from JIPMER (1), (2)working in health department