Heart Auscultation Quiz
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Healthy 7 year old boy. Normal growth and development, no symptoms. Routine physical exam. Normal heart action and pulses. You listen at the apical area using the stethoscope bell.
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3.1 Heart rate normal for age
3.2 S1 is single
3.3 S2 is single, as expected at the apex. P2 can not normally be heard except at the left upper sternal edge
3.4 Systole: a 3/6 vibratory murmur, ejection type
3.5 Diastole: a very low pitched S3 in early diastole. The separation from S2 is too wide to be a widely split S2
Conclusion: Innocent (vibratory, musical) murmur, S3, both normal at this age. The murmur is due to tissue vibration inside the heart and usually disappears by puberty. Innocent murmurs often are louder in the supine position than upright. This one is louder than most innocent murmurs.
His heart rate is:Correct
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