II. Epidemiology

  1. Common murmur in age 2-5 years

III. Physiology

  1. Not a true murmur
  2. Represents noisy Jugular Vein flow

IV. Signs

  1. Continuous murmur with diastolic prominence
  2. Low frequency
  3. Intensity: Grade I to II of VI murmur
  4. Quality: Whining, roaring, or whirring
  5. Best heard in right infraclavicular area, low anterior neck lateral to sternocleidomastoid muscle
  6. Temporarily resolves with maneuvers
    1. Jugular Vein compression on affected side
    2. Supine position
    3. Turning head to affected side

V. Differential Diagnosis

  1. Patent Ductus Arteriosis (PDA)
  2. AV Fistula

VI. Course

  1. Innocent murmur

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