11.4 Lifespan Considerations

The assessment of the cardiovascular system and its expected findings should be adjusted based on common variations throughout different life stages.

Newborn

It is common for infants to have murmurs in the first day of life, but these are typically transient. When evaluating a murmur in infants, it is important to measure blood pressure in both the upper and lower extremities to check for narrowing of the aorta. Before discharge, screening for congenital heart disease should include pulse oximetry.^[1]

Pediatrics

When evaluating the cardiovascular system in children, it is crucial to carefully assess the apical pulse. It’s important to note that the expected findings for the apical pulse may vary according to the child’s specific age group. Furthermore, once a child reaches adolescence, it is appropriate to evaluate the radial pulse.

Older Adults

As individuals age beyond 65 years, there is an increased likelihood of experiencing irregular heart rhythms and the presence of additional sounds. Specifically, an “irregularly irregular” rhythm may be indicative of atrial fibrillation, a condition characterized by an erratic heartbeat. In the event that this irregular rhythm is newly detected, it is essential to conduct further investigation.^[2]