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A 5-year-old girl is being seen for a well-child visit. On exam the practitioner auscultates a heart murmur. The mother says that the child has never been diagnosed with a murmur.
What focused history (HPI) questions would you ask the parent/child with regard to the presence of a heart murmur. Use OLDCARTS.
What subjective information provided by the parent/child would be a potential “red flag” warranting referral?
What components of the physical exam are pertinent to perform on this patient? Be specific and explain why you are performing the exam.
What physical exam techniques should you use to assess the heart murmur in this child? Briefly describe the maneuvers and the expected findings.
Discuss the types of murmurs found in children. Discuss the grades, timing, and character of the various murmurs. How is a murmur documented in the physical exam findings?
What objective information would be considered a red flag warranting referral in this child with a newly auscultated murmur? Explain.
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