Described is an implantable cardiac device, comprising:a pressure sensor (100) adapted for disposition so as to sense the acoustic vibrations produced by a systolic murmur and produce a pressure signal reflective thereofcircuitry (103) for measuring the intensity of the systolic murmur from the pressure signal produced by the pressure sensor (100)an impedance sensor (95) configured to measure transthoracic impedance reflective of cardiac volumea controller (10) programmed to record a baseline murmur intensity and,wherein the controller (10) is further programmed to measure a current murmur intensity as an average of intensity measurements taken over some period of time, compare the current murmur intensity to the baseline murmur intensity, and detect a change indicative of worsening cardiac status if the current murmur intensity exceeds the baseline murmur intensity by a first specified threshold amount and if the transthoracic impedance measurement indicates an increase in cardiac volume above a second specified threshold amount.
