Heart Auscultation Quiz
Case 3
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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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Answers
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 S2Conclusion: 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.
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Question 1 of 5
1. Question
His heart rate is:
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Question 2 of 5
2. Question
Describe S1:
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Question 3 of 5
3. Question
Describe S2:
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Question 4 of 5
4. Question
Describe systole:
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Question 5 of 5
5. Question
Describe diastole:
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Hint
- Case 1: 4 year old boy, listening at left upper sternal edge
- Case 2: 20 year old female, listening at left upper sternal edge
- Case 3: 7 year old male, listening at apex with the bell
- Case 4: 7 year old girl, listening at left lower sternal edge
- Case 5: 4 year old girl, listening at left upper sternal edge
- Case 6: 4 year old boy, listening at left upper sternal edge
- Case 7: 10 year old boy, listening at left upper sternal edge
- Case 8: 10 year old boy, listening at apex
- Case 9: 9 year old boy, listening at left sternal edge