Innocent Murmurs Flashcards¶
Anki-compatible flashcards for Innocent Murmurs board review.
Q: What are the 6 S's of innocent murmurs? A: Soft, Short, Systolic, Single S2, Symptom-free, no abnormal Sounds (no clicks, no gallops) Tags: innocent-murmur, diagnosis, high-yield
Q: What is the most common innocent murmur in children aged 3-7 years? A: Still's murmur - low-pitched, vibratory/musical, grade 1-2/6, best at LLSB, louder supine Tags: innocent-murmur, stills, high-yield
Q: What is the typical location and quality of a Still's murmur? A: LLSB to apex, vibratory/musical ("twanging string"), low-frequency, grade 1-2/6 Tags: innocent-murmur, stills
Q: What innocent murmur is heard at the upper sternal borders in children? A: Pulmonary flow murmur - soft, ejection quality at LUSB, no click, normal S2 split Tags: innocent-murmur, pulmonary-flow
Q: What causes a venous hum and where is it heard? A: Turbulent flow in jugular veins; heard at right (or left) supraclavicular area; continuous but disappears with head turning or supine position Tags: innocent-murmur, venous-hum
Q: How do you distinguish a venous hum from a PDA murmur? A: Venous hum: disappears with head turning, lying supine, or gentle jugular compression. PDA murmur: continuous machinery murmur at left infraclavicular area, doesn't change with position Tags: innocent-murmur, venous-hum, differential
Q: What maneuver increases the intensity of most innocent murmurs? A: Supine position, fever, anemia, anxiety, exercise (anything that increases cardiac output) Tags: innocent-murmur, physical-exam
Q: What murmur characteristics suggest pathology rather than innocence? A: Diastolic murmur, holosystolic murmur, harsh quality, grade 3+, abnormal S2, associated click, radiation to back/neck, thrill, symptoms Tags: innocent-murmur, red-flags, high-yield
Q: Do innocent murmurs require echocardiography? A: NO - if classic innocent murmur features are present and no concerning findings, echo is not needed Tags: innocent-murmur, workup, high-yield
Q: What is a peripheral pulmonary stenosis (PPS) murmur and when is it heard? A: Soft systolic murmur radiating to axillae and back; common in newborns due to acute angle of branch PAs; resolves by 6 months Tags: innocent-murmur, pps, newborn
Q: What innocent murmur may be heard in a thin, athletic adolescent? A: Supraclavicular arterial bruit - harsh, brief, heard above clavicles, decreased by shoulder hyperextension Tags: innocent-murmur, arterial-bruit
Q: At what age does Still's murmur typically resolve? A: Often disappears by adolescence Tags: innocent-murmur, stills, prognosis
Q: What is the significance of a normal S2 in evaluating a murmur? A: Normal S2 split (widens with inspiration) essentially rules out significant structural heart disease; fixed split suggests ASD Tags: innocent-murmur, physical-exam, s2
Q: When should you refer a child with a murmur to cardiology? A: Diastolic murmur, holosystolic murmur, symptoms (cyanosis, failure to thrive, exercise intolerance), abnormal S2, associated abnormalities, grade ≥3/6 murmur Tags: innocent-murmur, referral, high-yield
Q: What do you tell parents about innocent murmurs? A: "Your child's heart is completely normal. The murmur is just the sound of normal blood flowing through a healthy heart. No restrictions, no follow-up needed, and it will likely go away as they grow." Tags: innocent-murmur, counseling