Sandefur Initial Post NURS 6501 Week 5 Disc. 1 Cardiovascular Alterations A heart murmur is an unusual sound heard between heartbeats that is caused by turbulent blood flow through the heart valves, often described as a whooshing or swishing sound (National Heart, Lung, and Blood Institute, 2016). In children, a murmur is typically caused by a congenital heart defect or valve abnormality (National Heart, Lung, and Blood Institute, 2016). In adults, valvular lesions are the primary cause (Hammer & McPhee, 2014). Turbulent blood flow is the result of either the narrowing of the mitral valve or the incompetence of the aortic valve, and these defective heart valves may be the result of a disease process or heart condition (Hammer & McPhee, 2014). According to the National Heart, Lung, and Blood Institute (2016), murmurs can also be caused by conditions that temporarily increase blood flow, such as exercise, pregnancy, and anemia. Diagnosing and Treating the Patient in this Scenario In this scenario, the 16-year-old patient initially presented at a sports physical with no significant medical history and no family history of cardiovascular disorders. However, upon physical examination the nurse hears a grade II systolic heart murmur which can be auscultated loudest at the apex of the heart. Murmurs are graded from 1-6, with 1 being very faint and 6 being the loudest (American Heart Association, 2016). This patient has a grade 2 murmur, and according to the American Heart Association, quiet murmurs such as grade 1-2 are more likely to be benign. To diagnose this patient, the provider would need to listen to the sound, location, and duration of the murmur and take the patient’s medical and family history into consideration to determine if the murmur is harmless, or the result of a more serious condition (National Heart, Lung, and Blood Institute, 2016). A CT scan, EKG, echocardiogram, or chest x-ray may be ordered to discover the cause of the murmur (American Heart Association, 2016).

Since this particular patient is an athlete, a stress test should be ordered to demonstrate how the heart performs during physical activity or exercise (National Heart, Lung, and Blood Institute, 2016). The treatment of a murmur depends on the root cause, and can range from medications to surgery to cardiac catheterization (National Heart, Lung, and Blood Institute, 2016). Impact of Behavior on Diagnosis and Treatment This patient is a 16-year-old male who plays sports, so behavior is a significant factor that affects his diagnosis and treatment. Although he has no past or family history of heart problems and no physical