The Murmur in a Well Child

What this deck covers

The Murmur in a Well Child in twelve clinical teaching 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.

The 12 cases, in order

1. How common they are
2. Timing in the cycle
3. What loudness means
4. The posture test
5. When systole is quiet
6. The decoy and the signal
7. Radiation, and quality
8. The continuous exception
9. Beyond the stethoscope
10. Words that reassure
11. A murmur that has changed
12. The natural history

Diagnoses and management options tested

Across the twelve cases you are asked to choose between options such as: An atrial septal defect, An innocent murmur, A small ventricular septal defect, Mild aortic stenosis, Continuous, running through both heart sounds, Loudest in diastole, after the second sound, Pansystolic, touching both of the heart sounds, Very little on its own, A louder murmur means a larger problem, The grade alone decides whether to refer, Get louder on standing, Stay exactly the same, Get quieter when he stands up, Disappear when he lies flat, A Still’s murmur, Aortic stenosis, Mitral regurgitation, A patent ductus arteriosus, An arteriovenous malformation, A venous hum, Aortic regurgitation, Take a detailed family history, Feel the femoral pulses, Take blood cultures before any antibiotic, Most disappear by adolescence.

Clinical pearls from this deck

• Grade measures how much noise reaches your ears, not how much is wrong with the heart.
• Innocent murmurs are flow murmurs: the noise comes from the volume crossing a normal outflow tract.

The twelve worked cases in this deck, with the images and the full explanation of every option, are part of Pediatric Case Review membership. See what is included.

More from this system: all cardiology decks and question sets · pediatric reference values.