murmurs/ congenital heart disease

Question 1

Heard best at Left lower sternal border
Midsystolic murmur
Vibratory quality 
decrease with valsalva or standing
increase with supine and hyperdynamic states

Answer 1

Still murmur

Question 2

Continuous murmur 
Right sternal border, infraclavicular
no radiaition 
Increase with sitting or being upright 
Decrease with supine, jugular compression, rotation and flexion of head

Answer 2

cervical venous hum

Question 3

No murmur

many are asymptomatic, though may have strokes from paradoxical embolism, may have migrains

Answer 3

Patent foramen ovale

Question 4

systolic ejection murmur upper left sternal border, wide fixed and split s2
no variation with respirations
Pt may have reccurent respiratory infection, exertional dysonea, syncope, paradoxical emboli

Answer 4

Atrial septal defect

Question 5

Machine like murmur loudest at pulmonic area, wide pulse pressures and bounding pulses.
infants may have failure to thrive and respiratory infections
use NSAIDs as primary tx (indomethacin)

Answer 5

Patent ductus arteriosus

Question 6

systolic murmur radiating to the scapula/ back
associated with bicuspid aortic valve
delayed femoral pulses
difference of blood pressures between LE and UE
may have bilateral claudication

Answer 6

coarctation of the aorta

Question 7

Harsh systolic murmur at left mid to upper sternal border
Has spells if deepening cynosis and fussyness
cyanotic heart disease

Answer 7

Tetrology of fallot

Question 8

usually cyanotic

egg on a string on xray

Answer 8

Transposition of the great vessels

Question 9

high pitched pansystolic murmur heard at the left lower sternal border
radiates across entire precordium
Thril of diastolic rumble at mitral area possible
palpable thrills may be present

Answer 9

Vetricular septal defect

Question 10

Single heart sound present (S2)

EKG: LVH

Answer 10

Tricuspid atresia