module 2 - cardaic Flashcards
Direction of heart sounds for clicks and murmurs - URSB
aortic vale clicks of aortic stenosis, venous hum
Direction of heart sounds for clicks and murmurs - ULSB
pulmonary valve clicks of pulmonary stenosis
pulmonary flow murmurs
ASD
PDA, venous hum
Direction of heart sounds for clicks and murmurs - LLSB
VSD, still murmur, tricuspid valve regurg, hypertrophic cardiomyopathy, subaortic stenosis
Direction of heart sounds for clicks and murmurs - Apex
aortic or mitral valve regurgitation
Direction of heart sounds for clicks and murmurs - Erb point (left sternal border between 2nd and 3rd intercostal space)
aortic ejection click or aortic stenosis or dilated aortic root
Innocent murmur - auscultatory findings
- grade 1 -III/IV in intensity and localized
- changes with position
- may vary in loudness
- may increase in loudness with illness or exercise
- musical or vibratory in quality (sometimes blowing)
- systolic in timing (except for venous hum - continuous)
- duration is short
- best heard in LLSB
- may disappear with Valsalva maneuver
- VS and ECG normal
possible pathologic murmur -auscultatory findings
- in a child with a syndrome
- any diastolic murmur
- systolic murmur with a thrill
- pan-systolic murmur
- continuous that can’t be suppressed
- systolic clicks
- opening snaps
- fixed splitting of 2nd HS
- accentuated S2
- S4 gallop
- not positional
- grade IV or higher
- harsh quality
Stills Murmur
- innocent
- heard 3-6 yo
- systolic ejection murmur
- LLSB or between LLSB and apex
- grade 1-III
- vibratory/musical
- decreases in upright position
Venous hum
- innocent
- heard 3-6 yo
- grade I-III
- louder in upright position
- changes with compression of jugular vein or turning head
carotid bruit
- innocent
- any age
- Systolic ejection murmur
- neck, over carotid artery
- grade I-III
Adolescent ejection murmur
- innocent
- 8-14 yo
- LUSB
- softer in upright position
- does not radiate to back
Normal Peripheral Pulm stenosis murmur
- innocent
- newborn- 6mo
- systolic ejection murmur
- axilla and back, LUSB/RUSB
- harsh, short, high frequency
CHF - S&S in infants
- Tachypnea
- tachycardia
- rales or wheezing
- cardiomegaly or hepatomegaly
- periorbital edema
- poor feeding/tires easily
- poor weight gain
- diaphoresis
CHF - S&S in kids and teens
- tachypnea
- tachycardia
- rales or wheezing
- cardiomegaly or hepatomegaly
- orthopnea
- SOB or dyspnea with exertion
- peripheral edema
- poor G&D
Heart condition for premature infant
PDA