In cardiac physiology, the Levine grading scale is a numeric scoring system to characterize the intensity or the loudness of a

heart murmur Heart murmurs are unique heart sounds produced when blood flows across a heart valve or blood vessel. This occurs when turbulent blood flow creates a sound loud enough to hear with a stethoscope. Turbulent blood flow is not smooth. The sound di ...

. The

eponym An eponym is a person, a place, or a thing after whom or which someone or something is, or is believed to be, named. The adjectives which are derived from the word eponym include ''eponymous'' and ''eponymic''. Usage of the word The term ''epon ...

is from researcher

Samuel A. Levine Samuel Albert Levine (January 1, 1891 – March 31, 1966) was an American cardiologist. The Levine scale, Levine's sign and Lown–Ganong–Levine syndrome are named after him. The Samuel Albert Levine Cardiac Unit at Brigham and Women's Hospita ...

who studied the significance of systolic heart murmurs. The grading gives a number to the intensity from 1 to 6: The palpable murmur is known as thrill, which can be felt on grade 4 or higher. # The murmur is only audible on listening carefully for some time. # The murmur is faint but immediately audible on placing the

stethoscope The stethoscope is a medical device for auscultation, or listening to internal sounds of an animal or human body. It typically has a small disc-shaped resonator that is placed against the skin, and one or two tubes connected to two earpieces. ...

on the chest. # A loud murmur readily audible but with no thrill. # A loud murmur with a thrill. # A loud murmur with a thrill. The murmur is so loud that it is audible with only the rim of the stethoscope touching the chest. # A loud murmur with a thrill. The murmur is audible with the stethoscope not touching the chest but lifted just off it. The Levine scaling system persists as the gold standard for grading heart murmur intensity. It provides accuracy, consistency, and interrater agreement which are essential for diagnostic purposes, particularly to distinguish

innocent Innocence is a lack of guilt, with respect to any kind of crime, or wrongdoing. In a legal context, innocence is to the lack of legal guilt of an individual, with respect to a crime. In other contexts, it is a lack of experience. In relation ...

from pathological murmurs. Louder murmurs (grade ≥3) are more likely believed to represent cardiac defects that tend to have hemodynamic consequences. The Levine scale is usually written down as a fraction of 6 and in

Roman numerals Roman numerals are a numeral system that originated in ancient Rome and remained the usual way of writing numbers throughout Europe well into the Late Middle Ages. Numbers are written with combinations of letters from the Latin alphabet, eac ...

, as in a scale of II/VI.Heart Sounds Made Incredibly Easy!, Volume 1
Lippincott Williams & Wilkins, Oct 1, 2004; page 106.

References

{{Cardiovascular system symptoms and signs Heart murmurs Turbulence