24. What is the term for the cardiac murmur that can be heard in a patient with hyperthyroidism?

The Means-Lerman scratch is a mid-systolic murmur heard in the setting of a hyperthyroid state at the left upper sternal border and end-expiration. This is thought to occur from rubbing of the pericardium against the the pleura in the high output, hyperdynamic states of hyperthyroidism and may sound similar to a pericardial friction rub as seen in pericarditis.