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The diagnosis of innocent murmurs in childhood

Published online by Cambridge University Press:  19 August 2008

Najib Advani
Affiliation:
Department of Cardiology, Royal Children's Hospital, Melbourne, Australia
Samuel Menahem*
Affiliation:
Department of Cardiology, Royal Children's Hospital, Melbourne, Australia
James L. Wilkinson
Affiliation:
Department of Cardiology, Royal Children's Hospital, Melbourne, Australia
*
Professor S. Menahem, Department of Cardiology, Royal Children's Hospital, Flemington Road, Parkville, Victoria, 3052, Australia Tel. +61–3–9345–5178, Fax: +61–3–9345–6001, E-mail. menahems@cryptic.rch.unimelb.edu.au

Abstract

Innocent murmurs are common in childhood. They require accurate diagnosis to avoid unnecessary anxiety and/or restrictions. With this in mind, we studied prospectively children diagnosed by a paediatric cardiologist as having innocent murmurs to review the necessity of investigations in excluding organic abnormalities. We included 63 children in the study. The majority had the so-called Still's, or musical/vibratory murmur. None had abnormal investigations, suggesting that such investigations are largely superfluous for the purpose of diagnosis in those patients with innocent murmurs seen by a paediatric cardiologist. They are often done, nonetheless, as part of the assessment and/or expectations of the parent or the referring physician.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2000

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References

Rosenthal, A. How to distinguish between innocent and pathologic murmurs in childhood. Pediatr Clin North Am 1984; 31: 12291329.CrossRefGoogle ScholarPubMed
Menahem, S. Innocent and other murmurs in childhood. Australian Doctor, 1997, Nov, 18.Google Scholar
Pelech, AN. Evaluation of the paediatric patient with a cardiac murmur. Pediatr Clin Nth Am 1999, 46: 167188.CrossRefGoogle ScholarPubMed
Caceres, CA, Perry, LW Still's murmur. In The Innocent Murmur: A problem in clinical practice. Little Brown and Co, Boston 1967; 115160.Google Scholar
Still, GF. Common disorders and diseases of childhood. Frowde, Hodder and Stroughton, London 1909; p731.Google Scholar
Fogel, DH. The innocent systolic murmur in children: a clinical study of its incidence and characteristics. Am Heart J 1960; 59: 554558.CrossRefGoogle ScholarPubMed
Smythe, JF, Teixeira, OHP, Vlad, P, Demers, PP, Feldman, W. Initial evaluation of heart murmurs: Are laboratory test necessary? Pediatrics 1990; 86: 497500.CrossRefGoogle Scholar
Geva, T, Hegash, J, Frand, M. Reappraisal of the approach to the child with heart murmur; is echocardiography mandatory? Int J Cardiol 1988. 107113.CrossRefGoogle Scholar
Newburger, JW, Rosenthal, A, Williams, RG, Fellows, K, Miettinen, OS. Non-invasive tests in the initial evaluation of heart murmurs in children. N Eng J Med 1983; 308: 6164.CrossRefGoogle Scholar
Davignon, A, Rantaharju, P, Boisselle, E, Soumis, F, Megelas, M, Choquette, A. Normal ECG standards for infants and children. Ped Cardiol 1979, 1: 123131CrossRefGoogle Scholar
Saunders, NR. Innocent heart murmurs in children—Taking a diagnostic approach. Can Fam Phys 1995; 41: 15071512.Google ScholarPubMed
Danforth, DA, Nasir, A, Gumbiner, C. Cost assessment of the evaluation of heart murmurs in children. Pediatrics 1993; 91: 365368.CrossRefGoogle Scholar
McCrindle, BW, Shaffer, KM, Kan, JS, Zahka, KG, Rowe, SA, Kidd, L. An evaluation of parental concerns and misperceptions about heart murmurs. Clin Pediatr 1995; 2531CrossRefGoogle ScholarPubMed