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 Murmur intensity is categorized on a scale of 1 (very quiet) to 6 (very loud).

 In general, soft murmurs (grade 1 and 2) are non‐pathologic while the louder murmurs are associated with pathology in the heart. However, there are exceptions to this rule‐of‐thumb.

Grade 1

 Very soft, small area; the heart must be auscultated for several minutes to detect.

Grade 2

 A faint murmur. The heart must be auscultated for a short period to detect.

Grade 3

 The murmur is readily heard when auscultation begins. It is localized.

Grade 4

 A loud murmur which is widespread (radiates), but there is no palpable thrill (vibration felt on the chest wall).

Grade 5

 A loud, widespread murmur with a palpable thrill.

Grade 6

 A very loud widespread murmur with a palpable thrill. The murmur can still be heard when the stethoscope is lifted slightly off of the chest wall.