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Heart murmurs - Coggle Diagram
Heart murmurs
Innocent ejection murmur
vast majority of children with murmurs have a normal heart
Hallmarks = the 5 S's
aSymp patient
Soft
Sys
@ left Sternal edge
normal heart sounds, no added sounds
no parasternal thrill
doesn't radiate
often heart during febrile illness / anaemia
re examine child once these corrected
How does CHD present?
antenatal US dx
heart murmur = most common
HF
shock
cyanosis
Features suggesting a murmur is significant
heard all over praecordium
loud
thrill (i.e. grade 4-6)
dias
a/w other abnormal cardiac signs
Reporting murmurs
Timing
sys
dias
continuous
Duration
mid-sys (ejection)
pansys
sys murmurs graded based on loudness
1/2: soft, difficult to hear
3: easily audible, no thrill
4-6: loud, no thrill
site of max intensity
mitral
pul
aortic
tricuspid
radiation
neck: aortic stenosis
back: coarctation of aorta
Murmurs often not heard in neonates with shunts
due to high pul vasc resistance
may only become apparent @ several wks when resistance falls
Heart sounds
fixed splitting of S2: ASD
S3 in mitral area normal in young children