Cardiovascular

Question 1

What is the most common heart defect?

Answer 1

VSD is the most common defect

Question 2

Congenital heart defects result from abnormal structural development of the heart and/or vessels. Most heart defects occur within the first _____ weeks of gestation

Answer 2

first 8 weeks of gestation

Question 3

Murmurs

Answer 3

Are a result of turbulent blood flow through the heart. They are evaluated based on timing within the normal heart cycle (systolic vs diastolic), intensity (I-VI), location, radiation, pitch, and quality. They can be innocent or pathologic

Question 4

Innocent Murmurs

Answer 4

Murmurs that are not associated with any anatomic abnormality. They are also referred to as functional, still’s or vibratory

Question 5

What is the most common innocent murmur?

Answer 5

Still’s murmur; heard most frequently from 3 to 7 years of age

Question 6

What four diagnoses account for majority of murmurs noted in children?

Answer 6

1. Patent ductus arteriosus (PDA)
2. Ventricular Septal Defect (VSD)
3. Innocent Murmur
   d. Peripheral pulmonic stenosis (PPS) of the newborn

Question 7

What are the characteristics of a typical Still’s murmur?

Answer 7

1. Systolic (LLSB out to apex)
2. Low intensity (grade 1 to 3)
3. Short duration, NOT holosystolic (never associated with precordial thrill)
4. Well localized, poorly transmitted
5. Intensity typically varies with position change (louder when supine) or respiration

Question 8

Abnormal heart sounds in systole and/or diastole

• May be associated with thrill, gallop, click, lift or heave
• Sound does not change with body position or respirator
• Diastolic mururs are ALWAYS pathologic
• for a murmur to be graded IV/VI, there must be a palpable thrill

Answer 8

Pathologic murmurs

Question 9

What are common innocent murmurs

Answer 9

1. Still’s murmur
2. Low-intensity systolic ejection murmur:
   
   • physiologic peripheral pulmonary stenosis
3. venous hum
4. Pulmonary or aortic flow murmur