When To Refer 12 year old with respiratory infections History Auscultation Diagnosis Refer? Patient History 12 year old boy complains of headaches and periodic nose bleeds. Blood pressure elevated. History of frequent respiratory infections. Auscultation Findings FeatureFindings pansystolicNo clickNo harshYes loudYes splitYes location2LICS murmurYes Refer? Should you refer the patient? NoYes Table of Contents 14 month old girl. Failure to thrive. 26 month old boy 34 year old with fainting episode 410 year old with chest pain. 56 month old with poor appetite 612 year old with respiratory infections 7Twelve year old girl with periodic dizziness 8Eleven year old girl seen after bicycle accident 9Eight year old girl with elevated temperature 10Eight year old boy with generalized malaise 11Fifteen year old boy complains of dizziness