CLINICAL MEDICINE

MEDICINE

CARDIOLOGY

Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
day old newborn boy. Grade 2/6 medium-pitched systolic ejection murmur, best heard at L upper sternal border. Murmur radiates to the back and axillae.Most likely etiology?
A
Venous hum
B
Peripheral pulmonary stenosis
C
Vibratory (Still’s) murmur
D
Pulmonary flow murmur
E
VSD
Explanation: 

Detailed explanation-1: -II/VI: Faint but easily audible. III/VI: Loud murmur without a palpable thrill. IV/VI: Loud murmur with a palpable thrill. V/VI: Very loud murmur heard with stethoscope lightly on chest. VI/VI: Very loud murmur that can be heard without a stethoscope.

Detailed explanation-2: -Characteristics of the murmur A grade 1 murmur is barely audible, grade 2 is soft but easily heard, grade 3 is loud but not accompanied by a thrill, while grade 4 is associated with a thrill. Grade 5 and 6 are very loud murmurs which may be audible with stethoscope partly or completely off the chest.

Detailed explanation-3: -Systolic murmurs are graded on a six-point scale. A grade 1 murmur is barely audible, a grade 2 murmur is louder and a grade 3 murmur is loud but not accompanied by a thrill. A grade 4 murmur is loud and associated with a palpable thrill.

Detailed explanation-4: -Infection. Fever. Low red blood cell count (anemia) Overactive thyroid gland (hyperthyroidism) Heart valve disease.

There is 1 question to complete.