Pediatric Cardiovascular Disorders and Heart Murmurs Quiz

Murmurs and Cardiac Conditions

• Tetralogy of Fallot is associated with a holosystolic, harsh-sounding murmur loudest at the tricuspid area.

Calcium Blockers Contraindications

• Calcium blockers should be avoided in infants, children with CHF, and those taking beta blockers due to the risk of hypertension and cardiac arrest.

Syncope Causes

• Vasovagal syncope is the most common noncardiac cause of syncope.

Chest Pain Causes

• Myocarditis is the most common cardiac cause of chest pain in children.
• Asthma is the most common pulmonary cause of chest pain in children.

Dysrhythmias

• Sick sinus syndrome is a type of dysrhythmia caused by SA node dysfunction and should not be treated with calcium blockers.

Orthostatic Hypotension Evaluation

• Orthostatic hypotension should be evaluated using a tilt test in patients with chest pain who have Postural Orthostatic Tachycardia Syndrome (POTS).

Red Flags for Syncope

• Cardiac syncope is a red flag for syncope and should be evaluated for abnormal cardiac physical exam or ECG.
• Neurocardiogenic syncope is a red flag for syncope and should be evaluated for neurologic deficits.

Heart Murmur Characteristics

• The quality, intensity, location, radiation, and duration of the murmur are characteristics used to evaluate heart murmurs in infants, children, and adolescents.

Murmur Types

• Subvalvular aortic stenosis is characterized by turbulent flow in the left ventricular outflow tract.
• Peripheral pulmonary stenosis is associated with turbulent flow from arterial branches off the aortic arch.
• Superior vena cava syndrome is characterized by turbulent flow from jugular veins and superior vena cava.
• Patent ductus arteriosus is continuous and best heard at the left infraclavicular area.
• Aortic regurgitation is early diastolic, decrescendo, and high-pitched.
• Mitral valve prolapse is a late crescendo murmur with a midsystolic click.
• Tricuspid regurgitation is characterized by a holosystolic, high-pitched 'blowing' sound.
• Aortic stenosis is a crescendo-decrescendo ejection murmur, loudest at the heart base.
• Mitral stenosis follows the opening snap and is a delayed rumbling mid-to-late murmur.

Differentiating Normal from Pathologic Murmurs

• The quality, intensity, location, radiation, and duration of the murmur are characteristics used to differentiate normal murmurs from pathologic murmurs.