11: Cardiac Murmurs Flashcards
An electrical dysrhythmia that requires immediate treatment. Presentation includes sudden onset of rapid regular rhythm (>230 bpm—does not slow when infant is quiet), irritability, poor nippling, vomiting, tachypnea, cyanosis or ashen gray color, cold extremities.
Paroxysmal SVT
May also detect diminished to absent femoral pulses.
Coarctation of the aorta
A harsh, continuous, machinery-type or “rolling thunder” murmur.
Patent ductus arteriosus
It is secondary to turbulence caused by blood flow from the main pulmonary arteries to the peripheral pulmonary arteries, which are smaller than usual.
Peripheral pulmonic stenosis
Gallop rhythm; always abnormal and indicates congestive failure.
S4
A gallop is usually heard.
Hypoplastic left heart syndrome
Closure of aortic/pulmonic valves after ventricular ejection of blood.
S2
A short midsystolic murmur can be heard beginning on day 1 or 2.
Hypoplastic left heart syndrome
A systolic ejection murmur that radiates down the sternum to the apex and also to the interscapular area.
Coarctation of the aorta
Produced by vibration during ventricular filling; can be normal in the newborn.
S3
This murmur is benign, although it may persist until 3 months of age.
Peripheral pulmonic stenosis
Typically, a loud, harsh, blowing pansystolic murmur.
Ventricular septal defect
Localized to the second left intercostal space. It may radiate to the left clavicle or down the left sternal border.
Patent ductus arteriosus
Closure of tricuspid/mitral valves after atrial ejection of blood.
S1
It is often heard loudest in the back.
Coarctation of the aorta
The most common heart defect, accounting for 25% of cases of congenital heart disease.
Ventricular septal defect
Slight separation of valve sounds is evident after 24–48 hours of age and can result in this.
Split sound
Single S2 with click and systolic blood pressure differential of >20 mm Hg between upper and lower extremities may indicate _____.
Coarctation
A systolic murmur is heard bilaterally in both axillae and across the back.
Peripheral pulmonic stenosis
Best heard over the lower left sternal border, usually on the second or third day of life.
Ventricular septal defect
It usually presents on the second or third day of life. A hyperactive precordium, bounding pulses, and wide pulse pressure may be found.
Patent ductus arteriosus
