Tasty Morsels of EM 055 – Paeds Cardiology: Murmurs

5 Aug

As always, this is from the ever expanding google doc on bits and bobs I read and learn from and transfer here for all our learning pleasure.

Today we have some notes from a lecture by a paeds cardiologist at a recent national EM training day.

Murmurs in babies

  • mostly VSD and ASD
  • mostly picked up antenatally these days
  • TGA is the one often missed antenatally
  • poor feeding is the hallmark sign (as it seems to be of all bad things in neonates). If feeding alright then the murmur is unlikely to be a big problem
  • 92% of those with coarctation will have lost femoral pulses at 5 days (afraid I don’t have a reference for this). Which means some femoral pulses will be normal at discharge
  • less than a 20 mmhg difference between the upper and lower limbs is reassuring that there is no coarct
  • in his cardiology clinic they are trying to move away from echo for everyone (see the 2014 appropriate use guidelines for this)
  • recommended murmurlab.com and the pediatric ECG stat app

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