Can a heart murmur sound like a frog croaking?

Heart Murmurs That Sound Like Frog Croaking

No, heart murmurs typically do not sound like frog croaking. The only heart sound that resembles a frog croaking is the venous hum, which is an innocent continuous murmur with medium pitched, blowing character with diastolic accentuation. 1

Types of Heart Murmurs and Their Characteristics

Heart murmurs are classified based on their timing, intensity, location, and quality. None of the standard classifications specifically describe a frog-croaking sound:

• Innocent murmurs - Common in children and adults, representing turbulent flow not associated with structural cardiac defects 1

• Pathologic murmurs - Associated with structural cardiac defects that require further evaluation 1

• Still's murmur - An innocent murmur with medium pitched, vibratory character heard at the apex and sternal borders 1

• Venous hum - The closest to a "croaking" sound; medium pitched with blowing character and diastolic accentuation, heard at right or left upper sternal border 1

• Innocent pulmonary systolic murmur - Medium pitched, harsh character heard at left middle and upper sternal border 1

Characteristics of Venous Hum

The venous hum is the only heart sound that might be described as somewhat similar to a croaking sound:

• Heard at the right or left upper sternal border 1
• Has a medium pitched, blowing character with diastolic accentuation 1
• Disappears with jugular venous compression or when the patient lies supine 1
• Common in children and pregnant women 1

Other Continuous Innocent Murmurs

• Mammary souffle - Medium or high pitched, blowing character with continuous flow and systolic accentuation heard over or above the breasts 1
  • Disappears with compression of breast tissue 1
  • Heard in late stages of pregnancy or early puerperium 1

Clinical Significance and Evaluation

• Diastolic and continuous murmurs are generally pathologic and warrant further workup, with venous hum being a notable exception 2

• Heart murmurs are present in up to 80% of school children and 52% of adults 2

• Innocent murmurs are typically grade 1-2/6, crescendo-decrescendo, position-dependent, and mid-systolic without radiation 2

• Referral to a cardiologist is recommended for:

  • Diastolic murmurs (except confirmed venous hum)
  • Loud or harsh-sounding murmurs
  • Holosystolic murmurs
  • Murmurs that radiate to the back or neck
  • Signs or symptoms of cardiac disease 3

Pitfalls in Murmur Evaluation

• Relying solely on auscultation without considering patient position and maneuvers that can alter murmur characteristics 1

• Failing to recognize that innocent murmurs can sometimes be relatively loud (grade 3) and still not represent pathology 1

• Over-investigation of clearly innocent murmurs, leading to unnecessary healthcare utilization and parental/patient anxiety 4

• Assuming that systolic murmurs are always innocent - they can sometimes be associated with significant valvular pathology 5