The primary care pediatric nurse practitioner auscultates a new grade II vibratory, mid-systolic murmur at the mid sternal border in a 4-year-old child that is louder when the child is supine. What type of murmur is most likely?

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Quizplus · Accepted Answer

The characteristics of the murmur described suggest that it is a Still's murmur. Still's murmurs are innocent murmurs commonly heard in children between 2-7 years old. They are usually heard best at the lower left sternal border, are mid-systolic, vibratory, and grade II or III in intensity. They are typically louder when the child is supine and quieter or absent in the standing or sitting position. They are benign and do not require further evaluation unless there are other signs or symptoms present.

The Primary Care Pediatric Nurse Practitioner Auscultates a New Grade