Professional Documents
Culture Documents
I. See Also: Pediatric Murmur
I. See Also: Pediatric Murmur
See Also
A. Pediatric Murmur
II. History
A. Innocent murmur
I. Epidemiology
A. Sitting forward
B. Exercise or increased Heart Rate
C. Fever
D. Anxiety, Restlessness, or crying
II. Signs: Pathologic Murmur
I. Characteristics
A. Uniform: Constant
B. Crescendo: Increasing
C. Decrescendo (Diminuendo): Decreasing
D. Crescendo-Decrescendo: Diamond Shaped Murmur
II. Pitch
A. Low pitched
1. Best heard with bell chest-piece at light pressure
B. High pitched
1. Best heard with diaphragm at firm pressure
II. Dynamic Maneuvers
A. Position
1. Supine
2. Erect
3. Left lateral decubitus position
B. Exercise
II. Interpretation
1. Crescendo-decrescend character
2. Musical or vibratory murmur
3. Quiet murmur (Grade 2 or less)
4. Timing: Early systolic or mid Systolic Murmur
5. Location: Left sternal border or pulmonic area
b. Associated findings absent
1. Arrhythmia present
2. Symptoms: Chest
Pain, Palpitation, Dyspnea, Syncope
3. Sudden Cardiac Death Family History
4. Jugular Venous Pulsation abnormal
5. Arterial pulsation abnormal
1. Wide Pulse Pressure
2. Water-Hammer Pulse (rapidly rising,
bounding)
3. Weak, slow rising pulse
ii. Other abnormal precordial exam