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Heart Murmurs & Extra Heart Sounds — Know the Difference If you can master systolic vs diastolic murmurs and S3 vs S4, you’ll answer a huge portion of cardiac questions correctly. Step 1: Start with Timing — Systolic vs Diastolic Systolic murmurs = between S1 → S2 (Lub → Dub) Think: the heart is squeezing. Common systolic murmurs: • Aortic stenosis — harsh crescendo-decrescendo at right upper sternal border • Mitral regurgitation — holosystolic blowing murmur at apex → radiates to axilla • Tricu
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