Innocent and Pathological Murmurs

Question 1

What are the features that distinguish an innocent murmur from a pathological one?

Answer 1

Soft, no radiation, varies with posture, no clubbing, no cyanosis, no thrills, no clicks, no diastolic component, no arrhythmias, asymptomatic child, no failure to thrive.

Question 2

What is the most common innocent murmur in children?

Answer 2

Still’s murmur

Question 3

Which innocent murmur is being described here?
2-8 yrs. Mid systolic, low pitched sound at left lower sternal border and towards apex. provoked by fear, anaemia. abolished by hyperextension of the neck.

Answer 3

Still’s murmur

Question 4

Which innocent murmur is being described here?
2-5yrs. Continuous blowing noise under clavicles, occlusion of the inferior jugular vein or moving neck towards side of murmur gets rid of it, loudest when sitting, disappears lying supine.

Answer 4

Venous hum

Question 5

Which innocent murmur is being described here?
School age to adolescent. Soft, early mid systolic murmur. left upper sternal border, decreased when upright, louder supine.

Answer 5

Pulmonary flow murmur

Question 6

What causes a fixed splitting murmur in children?

Answer 6

ASD, VSD, AVSD

Question 7

What causes an ejection systolic murmur in children?

Answer 7

PS, AS, CoA

Question 8

What causes a pansystolic murmur in children?

Answer 8

VSD, MR

Question 9

What causes a continuous murmur in children?

Answer 9

Patent ductus arteriosus