PanSystolic

Pansystolic, also called holosystolic, describes a type of heart murmur that is heard throughout the entire systolic phase of the cardiac cycle. Unlike murmurs that have a discrete onset and offset, a pansystolic murmur begins with the first heart sound (S1) and continues uninterrupted until the second heart sound (S2). The continuous nature of the murmur is often due to abnormal blood flow through a heart valve or through a structural defect that allows back‑flow during each contraction.

Common causes of a pansystolic murmur include mitral regurgitation, tricuspid regurgitation, ventricular septal defect, and functional defects secondary to heart failure or pulmonary hypertension. In mitral regurgitation, for example, the incompetent mitral valve allows blood to flow from the left ventricle back into the left atrium during systole, producing a harsh, blowing murmur best heard at the apex and radiating to the axilla. Tricuspid regurgitation produces a similar murmur best heard at the lower left sternal border. A ventricular septal defect creates a holosystolic murmur heard at the left sternal border, often with a thrill.

Diagnosis is typically made by auscultation, supplemented by echocardiography to determine valve pathology and the severity of regurgitation or shunting. Management depends on the underlying cause: medical therapy may control symptoms and prevent progression, while surgical or catheter‑based interventions such as valve repair or patch closure are reserved for significant lesions or symptomatic patients. Early detection and appropriate treatment can reduce the risk of heart failure, pulmonary hypertension, and other complications associated with pansystolic murmurs.