Heart murmurs Flashcards
Pan systolic at lower left
VSD - softer the worse it is and developes a mid diastolic murmur due to increased flow accross the mitral valve. at the apex
continuous murmur heard loudest under the left clavicle.
PDA
Ejection systolic at upper left sternal edge with widely split second heart sound
ASD
LOUD ejection systolic at left UPPER sternal edge
Tetralogy of Fallot
no murmur
Transposition of the great arteries
Ejection systolic at upper left sternal edge with apical pan systolic
AVSD - due to AV valve regurgitation
ejection systolic heard at upper left sternal edge
No thrill heard
Pulmonary stenosis
ejection systolic at right sternal edge
delayed and soft second heart sound
carotid thrill
Aortic Stenosis
Heart failure with absent femoral pulses at 2 years.
coarctation of the aorta
What is the most common heart defect in downs
AVSD then VSD
TGA is NOT associated atall
What are the 4 defects of tetralogy of fallot?
Large VSD
Aorta lies over ventricular septum
Severe pulmonary outflow obstruction (subpulmonary stenosis)
RVH (as a result)
which cardiac abnormalities are duct dependant?
Right to left shunts: Tetralogy and transposition of GA.
plus: severe Aortic or pulmonary stenosis
What drug should be given in a sick child who you suspect may have a duct dependant abnormality?
Prostaglandins and antibiotics to cover for sepsis. An eco needs to be ordered to rule out sepsis.
What signs would be suggestive of heart failure in a child?
Usually occurs in left to right shunting when pulmonary resistance falls because this means less blood gets sent round the body and more goes back around to be oxygenated.
hep splen
fluid on lungs? crackles
What is a venous hum
continuous blowing noise just below the clavicles due to blood flow in the great veins returning to the heart
