Pediatric heart murmur

Question 1

CC: lightheaded ness and chest pain
PE: harsh crescendo-decrescendo systolic ejection murmur, radiates to carotids
- ejection click at apex
- increased left ventricular impulse

Answer 1

aortic stenosis
usually bicuspid aortic valve in children

Question 2

asymptomatic
continuous cardiac murmur heard at infraclavicular area, suoraclavicular area or USB
softens with supine and intensifies in seated position

Answer 2

cervical venous hum

Question 3

CC: DOE, syncope, orthopnea
PE: harsh crescendo-decrescendo murmur that increases with valsalva and decrease with squatting

Answer 3

Hypertrophic cardiomyopathy

Question 4

CC: headaches, dyspnea, claudication
PE: higher BP in arms than legs, delayed femoral pulse
systolic murmur with apical ejection click in left axilla, radiating to inter scapular area vent

Answer 4

coarctation of aorta

Question 5

mid systolic murmur at 2nd left intercostal space and fixed, split S2

Answer 5

atrial septal defect

Question 6

loud harsh holosystolic murmur at lower left sternal border