On day 20 of life holosystolic
murmur suggestive of PDA was heard on auscultation with no signs of cardiac failure.
Other pathological findings include a peripheral capillary oxygen saturation (SpO2) = 93%, disseminated bronchial rales on both anterior and posterior thorax lung areas, BP = 180/90mmHg, heart rate (HR) = 82 beats/min, regular heart rhythm, murmur of aortic calcification, 2nd/4th grade of mitral holosystolic
murmur, distended abdomen due to adipose tissue, meteorism, flatulence, and liver edge palpable at the costal margin.
A grade 3/6 holosystolic
murmur was heard best at the mitral area and radiated to the axilla.
Heart rhythm was normal but a holosystolic
blowing murmur with grade III intensity and a mid-to-late systole clicking murmur were readily audible in the apical region of the heart.
Most innocent murmurs are monitored appropriately in the primary care setting, but referral is more strongly suggested for murmurs of concern, which include holosystolic
murmurs, grade 3-6 murmurs, and diastolic murmurs.
* a 3/6 nonradiating holosystolic
murmur heard along the left upper sternal border
In advanced stages, there may be signs of valvular regurgitation and right heart failure which include elevated jugular venous pressure with accentuated V waves (in the presence of tricuspid regurgitation), diastolic murmur of pulmonary regurgitation, holosystolic
murmur of tricuspid regurgitation, right ventricular S3 gallop, pulsatile hepatomegaly, peripheral edema and ascites.
At this ER visit, he had a II/VI holosystolic
murmur, subconjunctival petechial hemorrhages, and bibasilar crackles.
The murmurs that cause this effect are often called holosystolic
. If S1 appears split it is either caused by a click or by asynchronous closure of the MV and TV.
Heart: Regular rate and rhythm with a high-pitched holosystolic
murmur heard at the left sternal border at the 4th intercostal space.
The child was cyanotic with early clubbing and a grade 3/6 holosystolic
murmer at the left sternal border.
Physical examination showed a slightly elevated temperature and jugular venous pressure, holosystolic
murmur, enlarged liver, abnormal pulse, and pleural effusions.