When a murmur is detected during an examination, what is the first quality that the examiner should assess?

When assessing a murmur, the first quality that should be evaluated is timing. Timing refers to when the murmur occurs in relation to the cardiac cycle, such as during systole or diastole. This initial assessment is crucial because it helps narrow down the possible underlying causes of the murmur. For example, systolic murmurs may suggest different pathologies compared to diastolic murmurs, including those related to normal blood flow or structural heart defects.

Understanding timing allows the healthcare provider to categorize the murmur appropriately, which can guide further assessment and management. Once the timing is established, additional characteristics such as location, intensity, and duration can be analyzed, but timing sets the foundation for the evaluation process.