Child Health 8 - Sam

The Case

He's got a murmur

Sam’s mother reports that he is feeding well (breast feeding). On examination you hear a 3/6 pan systolic murmur at the left lower sternal edge. The femoral pulses are easily palpable, there are no signs of respiratory distress and there is no hepatomegaly. The rest of the examination is normal.

Multiple Choice Question

What is the most likely cause of the murmur?

Open Question

Some children with congenital cardiac lesions will not have an audible murmur in the 1st few days of life, why is that?