cardiac murmurs in pediatrics

Question 1

what is a diffuse bugle outward of the left side of the chest

Answer 1

cardiomegaly

Question 2

Tachypena, tachycardia and hepatomegaly are all suggestive of what in infants

Answer 2

heart failure

Question 3

absence or diminution of femoral pulses is indicative of what

Answer 3

coarctation of aorta (narrowing of blood vessel)

Question 4

weak or thready pulses can be indicative of what?

Answer 4

myocardial dysfunction and Heart failure

Question 5

pathological arrhythmias

Answer 5

can be a structural cardiac lesion

Question 6

closing ductus

Answer 6

benign murmur heard in newborn, transient soft ejection in upper left sternal border

Question 7

peripheral pulmonary flow murmur

Answer 7

benign murmur heard in newborn-1year, soft slightly ejectile systolic to the left of upper left sternal border and in lung fields and axillae

Question 8

pulmonary valve stenosis

Answer 8

fusion of most of valve leaflets;

location: upper left sternal border
radiation: in mild degrees of stenosis the murmur may be heard over the course of the pulmonary arteries in the lung fields
intensity: increases with the degree of stenosis

Question 9

aortic valve stenosis

Answer 9

usually bicuspid valve with progressive obstruction

location: mid sternum upper right sternal border
radiation: to carotid arteries and suprasternal notch
intensity: varies louder with increasing severe obstruction
quality: harsh systolic murmur

Question 10

tetralogy of fallot

Answer 10

variable cyanosis that increases with activity
complex ventricular septal defect, with right to left shunting at ventricular level, right ventricular outflow obstruction, malrotation of the aorta
location: mid- upper left sternal border
radiation:in mild degrees of stenosis the murmur may be heard over the course of the pulmonary arteries in the lung fields
intensity: increases with the degree of stenosis
radiation: little
intensity: grade III-IV

Question 11

transposition of the great arteries

Answer 11

severe defect with failure of rotation of great vessel so aorta is attached to right ventricle and pulmonary artery from left ventricle
intense generalized cyanosis

Question 12

ventricular septal defect

Answer 12

blood going from high pressured left ventricle to low pressured right ventricle

location: lower left sternal border
radiation: little
intensity: variable
quality: usually harsh

Question 13

patent ductus arteriosus

Answer 13

continuous flow from aorta to pulmonary artery to the pulmonary artery

location: upper left sternal border
radiation: sometimes to the back
intensity: varies depending on size of shunt
quality: hollow machinery like murmur almost inaudible by late diastole.

Question 14

atrial septal defect

Answer 14

left to right shunt through the opening in the atrial septum, possible at various levels

location: upper left sternal border
radiation: to the back
intensity: variable
quality: not usually harsh