Pediatric Murmurs

Pediatric Murmurs

Cost: $FREE
Course Type: Online
Approximate Length: 1 hour

Welcome to training on Pediatric Murmurs, provided by the Texas Department of State Health Services (DSHS) and Health and Human Services Commission (HHSC).

Sample Clinical Case

Please review these three scenarios.

Scenario 1: A six-month-old infant presents for a well-child check. This is a vigorous baby with no concerning medical history, is pink and well perfused, and has normal vital signs. A heart murmur was noted. This is the first time a heart murmur had been commented upon in the medical record.

Scenario 2: A six-month-old infant presents for a well-child check. The child is poorly nourished and has "always had difficulty feeding." She is tachypneic. Her saturations are 98%. She has non-specific dysmorphic features. A heart murmur was noted for the first time on this evaluation. The remainder of examination was otherwise unremarkable.

Scenario 3: A six-month-old infant presents for a well-child check. The infant is pink and well perfused. She has had a relatively benign past medical history. Her growth has been adequate. Her vital signs are stable, although blood pressure could not be obtained because the infant was agitated. A murmur was noted for the first time. Lower extremity pulses were diminished.

Which infant has the more urgent need for pediatric cardiologist evaluation? Please choose your answer:

Goal

The goal of this module is to educate Texas Health Steps (THSteps) providers and others who care for pediatric and adolescent patients. The providers should be able to identify pathologic heart murmurs that require consultation for diagnosis and treatment by a pediatric cardiologist.

Target Audience

Texas Health Steps providers and others, including Physicians, Physician Assistants, Nurses, and Nurse Practitioners.

Specific Learning Objectives

After completing the activities of this module, you will be able to:

  1. Define heart murmurs.
  2. Identify two cardinal signs associated with pathologic heart murmurs in infants.
  3. Identify two cardinal signs associated with pathologic heart murmurs in older children.
  4. Identify general exam findings to observe before listening to the heart.
  5. Identify two physiologic conditions that may cause the child's heart to beat faster and make a murmur louder.
  6. Identify one question to ask a patient or his or her family about the pregnancy.
  7. Identify one question to ask a patient or his or her family about the patient's birth.
  8. Identify one question to ask a patient or his or her family about the patient's growth and development.
  9. Identify one question to ask a patient or his or her family about the patient's chest pains.
  10. Define the most important point of auscultation.
  11. Define the four cardinal heart sounds.
  12. Identify the most important point to understand about the grading system for heart murmurs.
  13. Identify two features of innocent heart murmurs.
  14. Identify two common innocent heart murmurs.
  15. Identify two features of pathologic heart murmurs.
  16. Identify a common cause of pathologic heart murmurs.
  17. Define the steps of the algorithm for infant referral to a pediatric cardiologist.
  18. Define the steps of the algorithm for older child referral to a pediatric cardiologist.

Please note this module expires in 12/18/2010.

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Lessons

Enroll in this course to access the lessons below. If you don't have an account, register and then login.

  • Pediatric Murmurs: Pre-Test
  • Section 1: Overview of Pediatric Murmurs
  • Section 2: History of Pediatric Murmurs
  • Section 3: Physical Exam for Pediatric Murmurs
  • Section 4: Evaluating Heart Murmurs
  • Section 5: Referral
  • Pediatric Murmurs: Post-Test
  • Pediatric Murmurs: Course Evaluation

Certificates

This module includes a pre- and post-test. Both tests need to be completed for you to receive a certificate of completion, and you must score a 75% on the post-test to pass. After you complete the post-test, you will be asked to evaluate your training experience, and you will be provided with information about securing continuing education credit. Click below for your certificate.

Disclosure Statements

One of the requirements of continuing education is disclosure of the following information to the learner:

  1. Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
    1. Create a Texas Health Steps account.
    2. Complete on-line registration process.
    3. Thoroughly read the content of the module.
    4. Complete the on-line examination.
    5. Complete the evaluation.
  2. Commercial Support.
    The THSTEPS Web-based Continuing Education Series has received no commercial support.
  3. Disclosure of Conflict of Interest.
    Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that neither planning committee members nor the authors of these modules have a conflict of interest.
  4. Non-Endorsement Statement.
    Accredited status does not imply endorsement by the Department of State Health Services, Continuing Education Service or the American Nurses Credentialing Center of any commercial products displayed in conjunction with an activity.
  5. Off-Label Use.
    Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).

The following are policies and definitions of terms related to continuing education disclosure:

The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.

All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.

↓ Disclosure: Glossary of Terms

Conflict of Interest – Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.

Commercial Interest – Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.

Financial Relationships – Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.

Off Label – Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).

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