Innocent and Pathological Murmurs – 18 Board-Style Cases with Answers

What this deck covers

Innocent and Pathological Murmurs in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Quieter when she sits up
2. Gone when he lies down
3. Listening to the second sound
4. Heard in both armpits
5. The half of the cycle that matters
6. Something you can feel
7. It never stops
8. New today, gone next month
9. What loudness is worth
10. Heard on the first day
11. On the morning of the list
12. Four children, one scan
13. Standing up and squatting down
14. Up into the neck
15. What the scan is looking for
16. Short, webbed, weak below
17. Can she still play football
18. It does not sound the same

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: A small ventricular septal defect, A persistent arterial duct, An atrial septal defect, in, Turbulence in the branch pulmonary arteries, A murmur audible in diastole, A pathological murmur requiring echocardiography, A flow murmur from fever and anaemia, It marks grade four and above, An innocent murmur varying with venous return, Pulmonary valve stenosis, in, Coarctation of the aorta, An atrioventricular septal defect.

Clinical pearls from this deck

• Musical, early, soft, and it fades when she sits up. That is the whole diagnosis.
• Lie him down and press the neck. If it goes, it is a hum.
• At the upper left sternal edge, listen to the second sound. It decides everything.
• A murmur in both axillae and the back at three weeks is usually the branch arteries growing.
• Systole needs judgement. Diastole needs a referral.
• If you can feel it, it is not innocent. That is the shortest rule in the examination.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Cardiology Board Questions case decks · pediatric reference values.