Murmurs and Heart Sounds

Question 1

Where is the apical pulse heard on the DOL 1?

Answer 1

Lower left sternal border

Question 2

Where is the apical pulse heard on DOL 7?

Answer 2

Midclavicular Line

Question 3

Where is PDA murmur heard?

Answer 3

Lower left sternal border

Loud machine like

Question 4

S1 heart sound?

Answer 4

Closure of mitral and tricuspid valves during ventricular systole.

Heard at Apex

Loud at birth and decreases in sound over 48 hours

Any factor increasing Cardiac Output will make S1 sound louder.

Question 5

S2 heart sound?

Answer 5

Closure of aortic and pulmonic valves

Heard loudly at base of heart

Question 6

If you hear only one heart sound and and have decreased pulmonary vascular markings, what is the problem?

Answer 6

Pulmonary Atresia

Pulmonary valve fails to develop and prevents blood from going out of the heart to the lungs.

Needs a PDA or PFO, give prostins

Question 7

When do PDAs close?

Answer 7

half by 24 hours
90% by 48 hours
All by 96 hours, unless failure to close

Question 8

How do you manage a PDA that didn’t close?

Answer 8

Respiratory support

Fluid restrict esp in first few weeks of life