Paeds Vivas · cardiology
Cardiovascular examination and murmur assessment — branching viva
Branching viva on the systematic paediatric cardiovascular examination, the innocent-versus-pathological murmur decision, the four-limb blood pressure and pre- and post-ductal saturation, the duct-dependent neonate and prostaglandin E1 resuscitation, and the hypercyanotic spell bundle.
On this page & tools
Target exams
Opening framework
My framework has three layers. First, the recognition — a heart murmur is audible turbulent flow, and the task at the bedside is to decide whether it fits the innocent fingerprint or departs from it. Second, the examination — a fixed sequence of inspect, palpate, auscultate, completed by a four-limb blood pressure and a pre- and post-ductal saturation, because these two measurements catch the lesions the stethoscope misses. Third, the disposition — reassurance for the complete innocent fingerprint, referral and echocardiography for any departure, and prostaglandin E1 for the suspected duct-dependent neonate before the echo confirms the lesion. [1]
You have read the opening of this viva. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.
References7Show ledgerHide ledger
- [1]Ford B, Lara S, Park J. Heart Murmurs in Children: Evaluation and Management. Am Fam Physician, 2022.PMID 35289571
- [2]Singh Y, Lakshminrusimha S. Perinatal Cardiovascular Physiology and Recognition of Critical Congenital Heart Defects. Clin Perinatol, 2021.PMID 34353581
- [4]Hueckel RM, Leyland C. Pediatric Murmurs. Nurs Clin North Am, 2023.PMID 37536793
- [8]Law MA, Collier SA, Sharma S, Tivakaran VS. Coarctation of the Aorta. StatPearls, 2026.PMID 28613663
- [9]Bailliard F, Anderson RH. Tetralogy of Fallot. Orphanet J Rare Dis, 2009.PMID 19144126
- [11]Johnson BA, Shepherd J, Bhombal S, et al. Special considerations for the stabilization and resuscitation of patients with cardiac disease in the Neonatal Intensive Care Unit. Semin Perinatol, 2024.PMID 39477714
- [12]van Roekens CN, Zuckerberg AL. Emergency management of hypercyanotic crises in tetralogy of Fallot. Ann Emerg Med, 1995.PMID 7832359