Peripheral Vascular Murmurs

WHILE it is commonplace in clinical procedure to hear murmurs over peripheral aneurysms and arteriovenous fistulae, it is but little appreciated that murmurs may also be heard over blood vessels in a great variety of conditions, particularly those characterized by a reduction in size of the vascular lumen. This paper is concerned with such locally generated murmurs in both arteries and veins, the mechanism of their formation, and their diagnostic significance. Optically registered examples of such murmurs will be presented, correlated in some instances with the roentgenangiograms. This clinical material will be preceded by an analysis of the theory of murmur formation. A presentation of experimental murmur formation by pneumatic cuff compression in normal subjects will also be offered in explanation of the murmurs encountered in obstructive lesions of the blood vessels. There are three distinct aspects to the problem of formation and appreciation of murmurs: the mechanism of their