Heart disease

Question 1

What are some common presenting features of heart failure?

Answer 1

Tachypnoea
Dyspnoea
Difficulty feeding
Sweating with feeding
Failure to thrive
Hepatomegaly

Question 2

How does the cardiothoracic ratio differ in children?

Answer 2

0.55 cf to 0.5

Can be 0.6 in infants

Question 3

What does a bounding pulse indicate?

Answer 3

Wide pulse pressure

• Aortic regurg
• Patent ductus arteriosus
• high cardiac states

Question 4

What is splitting? What is normal? What is abnormal?

Answer 4

Splitting of the second heart sound

Normal for the split to widen with inspiration

Fixed splitting can indicate an atrial septal defect

Question 5

What are the innocent murmurs?

Answer 5

Still’s murmur - short, mid-systolic, best between apex and left sternal edge, vibratory or slightly musical quality

Pulmonary flow murmur - blowing ejection murmur, maximal in pulmonary area, may radiate to axillae

Carotid bruit

Venous hum - high-pitched, continuous, heard over sternoclavicular junction