Hello and welcome to the zero to finals podcast.

My name is Tom and in this episode I'm going to be going to be going through

Pediatric Murmers.

And you can find written notes on this topic at zero tofinals.com slash murmurs or in the

zero to finals pediatrics book.

And you can find questions to train your knowledge on this content

and help you remember it for longer at members.0 to finals.com.

So let's get straight into it.

Let's start by talking about innocent murmurs.

Innocent murmurs, also known as flow murmurs, are very common in children.

They're caused by fast blood flow during systolee or systolic contraction of the ventricles.

Innocent murmurs have typical features which all begin with the letter S.

They are short, soft, systolic, symptomless, and situation-dependent,

meaning that the murmur gets quieter when standing or only appears when the child is unwell or feverish.

Innocent murmurs with no concerning features may not require further investigation.

Features that would prompt referral and further investigations include murmurs that are louder than two out of six,

diastolic murmurs, murmurs that are louder on standing, and other symptoms such as failure to thrive,

feeding difficulty, cyanosis, or shortness of breath.

Next let's talk about pancystolic murmurs.

Pancystolic murmurs occur throughout the systolic contraction of the heart

between the first and second heart sounds, S1 and S2.

Causes of pancystolic murmurs in children include mitral regurgitation, which is heard loudest in the mitral area,

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