1: Cardio - Innocent Murmurs Flashcards
What are innocent murmurs
Benign physiological murmurs heard in absence of underlying cardiac disease
What is the commonest cause of murmurs in children
Innocent murmurs
What % of children will have an innocent murmur
80%
What causes innocent murmurs
- Turbulent flow on outflow tract
What is a method to remember clinical features of innocent murmurs
4S
What are the 4S of an innocent murmur
Systolic
Soft
aSymptomatic
left Sternal edge
How may an innocent murmur be intensified
- Change in position
- Increased cardiac output such as exercise or fever
What are the three types of innocent murmur
- Ejection systolic
- Pulmonary systolic
- Venous brum
What causes a systolic ejection murmur
Generated in outflow tract
How will a systolic ejection murmur present
Soft brum
Where is a systolic ejection murmur heard
Left sternal edge
What are the characteristics of a pulmonary systolic murmur
Soft blowing, ejection-systolic murmur
What causes a pulmonary systolic murmur
Mild pulmonary stenosis
Where is a pulmonary systolic murmur best heard
Left sternal edge
What position is a pulmonary systolic murmur best heard
Supine
What causes a venous brum
Turbulent blood flow in great veins returning to the heart
How will a venous brum present
Low pitch grumbling below the clavicle
In what position will a venous brum dissapear
Supine
How should an innocent murmur in neonates be investigated
CXR
ECG
If CXR or ECG abnormal in neonates what should be done
ECHO
How should an innocent murmur be investigated in children
No investigation
Why are innocent murmurs investigated in neonates, but not children
As neonates CVS is rapidly changing, hence murmur could indicate underlying disease. Childs CVS is stable.
