Murmur

Congenital heart disease
Innocent murmur

  • Describe the anatomy of the cardiovascular system, explain the basic physiology of cardiac function, and be able to relate the anatomy and physiology to the cardiac physical exam finding
  • Describe the basic embryology of the heart and major vessels and how abnormalities in embryological development lead to the development of congenital heart defects
  • Describe the structural and dynamic changes that occur following birth in the cardiovascular system, including closure of the ductus arteriosus
  • Describe the classification system of murmurs

Overview & Foundational Knowledge

Frank JE & Jacobe KM.  Evaluation and Management of Heart Murmurs in Children.  American Family Physician 2011; 84: 793-800.

Review article on evaluation and management of murmurs.

Lucille Packard Children’s Hospital at Stanford: Overview of Congenital heart Disease

http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/cardiac/chd.html

Includes diagrams and written descriptions of all congenital heart disease; provides an approach to the diagnosis of congenital heart disease.

About Kids Health, SickKids Hospital: Resource Centres/Congenital Heart Conditions

http://aboutkidshealth.ca/En/ResourceCentres/CongenitalHeartConditions/UnderstandingDiagnosis/DiagnosisofCongenitalHeartDefects/Pages/default.aspx

Provides basic overview of congenital heart diseases, with brief animated videos demonstrating blood flow of oxygenated and deoxygenated through the heart. On side menu, select “diagnosis of congenital heart defects” and then select specific condition/defects from list.

Cincinnati Children’s Hospital Medical Center: Cardiac Anomalies / Congenital Heart Defects

http://www.cincinnatichildrens.org/patients/child/encyclopedia/defects/default/

Describes congenital heart disease, both cyanotic and acyanotic; navigate site by selecting specific CHD. Demonstrates differences between normal and abnormal hearts. Includes nice images and videos.

Clinical Resources

University of Washington: Demonstration of Heart Sounds & Murmurs

http://depts.washington.edu/physdx/heart/demo.html

This site includes audio demonstrations of heart sounds and murmurs, as well as includes links to the pathophysiology.

Virtual Patients or Cases

University of Michigan Heart Sound and Murmur Library

http://www.med.umich.edu/lrc/psb/heartsounds/index.htm

Audio of murmurs with cardiograms for visual representation.

Children’s Hospital Cleveland Clinic: Pediatric Radiology Image Gallery

https://www.cchs.net/pediatricradiology/imagegallery/default.asp

Image gallery of pediatric radiology; can be navigated by body system or by topic. Images labeled by presentation. On reviewing image, can select to have findings highlighted as well as diagnosis provided.

Clinical Presentations