Heart murmur historical perspective

A heart murmur is an unusual sound heard between heartbeats, physicians performed auscultation of the heart by placing their ear directly on the patient’s chest, a technique called “immediate auscultation”. The heart murmurs clearly described in detail by Allan Burns (1781–1813).

• In February 1818, the application of stethoscope was discovered by Laënnec at the Paris Academy of Sciences,later he published the work De l’auscultation médiate or Traité du Diagnostic des Maladies des Poumon et du Coeur.^[1]
• “Immediate auscultation” is a technique was performed at Hippocrates days, by placing the ear directly on the chest for examining the respiratory system. Instead, it was not appropriate for cardiac examination, as heart sounds were difficult to locate them from small and circumscribed precordial area.^[1]
• In 1816, Laennec was the first to created a paper acoustic device as a stethoscope to examine the chest. This technique “mediate auscultation” ^[1]
• In 1628, William Harvey first treated heart sounds in De Motu Cordis.^[1]
• Harvey, in his “visceral lectures” of 1616, compared heart sounds to “two clacks of a water bellows to rayse water.^{[2] [1]}
• In 1715, James Douglas, fellow of the Royal Society of London, heard severe aortic regurgitation murmur from the patient’s bedside.^[1]
• In 1757, The thrill (“particular vibratory movement”) and a murmur of arteriovenous fistula were described by William Hunter, professor of Anatomy to the Royal Academy, London^[1]
• Heart murmur clearly and in detail were described by Allan Burns, cardiologist and lecturer on anatomy and surgery at Glasgow.^[1]
• Laënnec was the one who teach cardiac auscultation, and in the subsequent years became a crucial component of cardiac physical examination, especially with rheumatic valvular disease.^[1]