Gradations of Murmurs

Grade 1 Very faint, heard only after listener has "tuned in"; may not be heard in all positions.

Grade 2 Quiet, but heard immediately after placing the stethoscope on the chest.

Grade 3 Moderately loud.

Grade 4 Loud, with palpable thrill (ie, a tremor or vibration felt on palpation).

Grade 5 Very loud, with thrill. May be heard when stethoscope is partly off the chest.

Grade 6 Very loud, with thrill. May be heard with stethoscope entirely off the chest.