Which murmur is commonly described as a vibratory murmur in children?

Which murmur is commonly described as a vibratory murmur in children?

• A. Pulmonary Ejection Murmur
• B. Vibratory Murmur
• C. Venous Hum
• D. Aortic Stenosis

Answer: (B)

In children, a murmur described as vibratory is the Still’s murmur, a benign flow murmur. It has a soft, musical or fluttering quality and is heard best along the left lower sternal border. It tends to occur in early to midsystole and is usually grade 1–2, appearing when the child is upright or supine and often becoming quieter or disappearing with age. The distinctive vibratory or musical sound comes from normal flow across the cardiac structures in a child with a high cardiac output, rather than from structural heart disease. This helps differentiate it from other common pediatric murmurs. A pulmonary ejection murmur is a soft systolic murmur heard at the left upper sternal border due to increased flow across the pulmonary valve, but it’s not typically described as vibratory. Venous hum is a continuous murmur heard above the clavicles that varies with position, not a brief vibratory systolic sound. Aortic stenosis is a harsh, sometimes crescendo-decrescendo systolic murmur that may radiate to the neck, not the gentle vibratory quality seen with Still’s murmur.

In children, a murmur described as vibratory is the Still’s murmur, a benign flow murmur. It has a soft, musical or fluttering quality and is heard best along the left lower sternal border. It tends to occur in early to midsystole and is usually grade 1–2, appearing when the child is upright or supine and often becoming quieter or disappearing with age. The distinctive vibratory or musical sound comes from normal flow across the cardiac structures in a child with a high cardiac output, rather than from structural heart disease.

This helps differentiate it from other common pediatric murmurs. A pulmonary ejection murmur is a soft systolic murmur heard at the left upper sternal border due to increased flow across the pulmonary valve, but it’s not typically described as vibratory. Venous hum is a continuous murmur heard above the clavicles that varies with position, not a brief vibratory systolic sound. Aortic stenosis is a harsh, sometimes crescendo-decrescendo systolic murmur that may radiate to the neck, not the gentle vibratory quality seen with Still’s murmur.