What describes a grade 4 murmur?

A grade 4 murmur is characterized by its loudness and the presence of a palpable thrill, which indicates that the vibration from the blood flow turbulence is strong enough to be felt on the chest wall with the hand. This level of intensity typically suggests significant hemodynamic changes or underlying pathology that warrants further investigation in a clinical setting.

In comparison, grade 1 murmurs are barely audible, while grade 2 murmurs are clearly audible but faint, and grade 5 murmurs are very loud and can be heard without direct contact, though a stethoscope is still needed. Therefore, the identification of a grade 4 murmur as loud with a palpable thrill is crucial for assessing the severity of the condition and guiding management decisions in patients suspected of having significant cardiac issues.