All are true about physiological murmur except
**Core Concept**
Physiological murmurs are sounds heard during cardiac auscultation that are normal and harmless, resulting from the flow of blood through the heart valves or great vessels. They are typically heard in young, healthy individuals and are characterized by their soft intensity and absence of radiation to other areas of the chest.
**Why the Correct Answer is Right**
The correct answer is related to the characteristics of physiological murmurs. Physiological murmurs are typically heard in specific locations, such as the pulmonary valve area, and are often associated with the closure of the valve. They are usually soft, grade 1-3, and do not radiate to other areas of the chest. The murmur of pulmonary flow, for example, is often heard at the left upper sternal border.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because physiological murmurs are not typically associated with a loud or harsh sound. While some physiological murmurs may be loud, they are generally soft and do not have a harsh quality.
**Option B:** This option is incorrect because physiological murmurs are not usually associated with a significant increase in cardiac output. While cardiac output may increase in certain situations, this is not a characteristic of physiological murmurs.
**Option C:** This option is incorrect because physiological murmurs are not typically associated with a significant change in the patient's symptoms. While some patients may have symptoms related to their underlying condition, the murmur itself is generally harmless and does not cause symptoms.
**Clinical Pearl / High-Yield Fact**
Physiological murmurs can be differentiated from pathological murmurs by their characteristics, including their location, intensity, and radiation. A murmur that is loud, harsh, or radiates to other areas of the chest is more likely to be pathological.
**Correct Answer:** A.