Which type of murmurs are considered always pathologic?

Diastolic murmurs are always considered pathologic because they typically indicate underlying heart disease or significant cardiac abnormalities. During diastole, the heart is filling with blood, and any abnormal sound during this phase usually suggests issues related to valve dysfunction, such as stenosis or regurgitation of the aortic or mitral valves.

In contrast, systolic murmurs can be either pathological or physiological, depending on the clinical context. Continuous murmurs may also result from structural abnormalities, but they are not limited to specific cardiac conditions and can sometimes occur due to other factors like vascular conditions. Physiologic murmurs are usually benign and can occur in healthy individuals, particularly in certain situations such as fever, anemia, or pregnancy, where blood flow dynamics change but do not indicate structural heart disease. Recognizing the pathological nature of diastolic murmurs is critical for further assessment and management of potential cardiac issues.