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Functional murmurs and the murmur associated with mitral valve prolapse and IHSS tend to be present only intermittently. As a rule, murmurs caused by valvular or congenital heart disease change only gradually over the years. Organic murmurs may radiate to the neck or axilla and may be associated with thrills (vibrations felt with the hand) or gallop rhythms (S3 and S4 sounds). … ................
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