[Verse 1] Under the crista, perimembranous hides, Tucked by the tricuspid's septal side, Aortic valve leans in as neighbor close, Eighty percent of holes, this is the one that shows. Thin fibrous rim, borders sharp and tight, Cusp can prolapse if pressure bites just right, Natural history: many seal with age, Watch the aortic leaflet like it's center stage. [Verse 2] Muscular defect, down in trabecular floor, Swiss cheese pattern, sometimes one, sometimes four, Neighbors are muscle, no valve within its reach, Most will shrink and vanish before the child can speak. Inlet type sits where the AV valves align, Outlet's doubly committed, under the semilunar line, Each has a postcode, each has its own affair, Learn the address of the hole that's living there. [Chorus] Piccolo buco, grande rumore, Small holes scream and big holes whisper low, Серце знає, sertse tells you so, Listen careful, let the murmur be your guide, Grande buco sits there quiet as the tide. [Verse 3] Small and restrictive, gradient stays severe, High-velocity jet screams loud and clear, Holosystolic, harsh at the sternal edge, Sats hold ninety-eight, no cyanotic pledge, Left atrium calm, the shunt's too small to strain, Watch it, wait it, closure comes without the pain, Pressure gradient high means the sound is fierce and bright, Tiny gap, tremendous noise — remember that tonight. [Verse 4] Large unrestrictive, pressures equalize, Softer murmur now, don't trust your ears, use eyes, Qp over Qs climbing past the two, Left atrium swelling, left ventricle too, Pulmonary flood, the lung fields drowning slow, Failure to thrive — that's your threshold, let it show, Close it before the vessels thicken and turn stone, Volume load today, resistance load unknown. [Bridge] Тиск росте — resistance climbing high, Reversal coming, watch the shunt reply, Murmur fading, sats begin to fall, Eisenmenger's shadow creeping on the wall, Clubbed fingers, cyanosis, purple lips appear, Operate early, chiudi la porta, don't wait here. [Chorus] Piccolo buco, grande rumore, Small holes scream and big holes whisper low, Серце знає, sertse tells you so, Listen careful, let the murmur be your guide, Grande buco sits there quiet as the tide. [Outro] One page, one card — position, border, name, Natural history written just the same, Complication, threshold, know them well, Piccolo buco, grande rumore — let the murmur tell, Serce mio, the size decides the sound, Small screams loudest, big loves stay quiet, safe and sound.
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