A six year old girl comes to your office for her annual check up. On physical examination, you note a normal S1 and S2 as well as a soft systolic murmur with a vibratory character, heard best over the right upper sternal border. You suspect an innocent murmur, but her mother asks if she should be referred to a cardiologist. Each of the following findings would support the diagnosis of a pathological murmur EXCEPT: a) the murmur occurs in diastole b) the murmur is associated with a thrill c) the murmur is louder in the supine position and softer when the child sits upright d) the child has mild finger clubbing e) there is a loud P2 component of the second heart sound
Posted on: Sat, 07 Sep 2013 15:27:04 +0000
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