How do you grade systolic murmurs ? Levine's grading of systolic murmurs (Ann Intern Med 1933; 6: 1371): • Grade 1: Murmur is so faint that it is heard only with special effort. • Grade 2: Murmur is faint but readily detected. • Grade 3: Murmur is prominent but not loud. • Grade 4: Murmur is loud. • Grade 5: Murmur is very loud. • Grade 6: Murmur is loud enough to be heard with the stethoscope just removed from contact with the chest wall.
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