Benign paediatric heart murmur

Benign paediatric heart murmur

A benign pediatric heart murmur, also innocent heart murmur or innocent murmur, is an inconsequential sound that originates from the heart and/or cardiovascular system and is heard on cardiac auscultation. By definition, an innocent murmur is not significant in the long-term health of an individual that has it.

Characteristics

*Soft, less than 3/6 in intensity (although note that even when structural heart disease is present, intensity does not predict severity.)
*Often position-dependent (Murmurs heard while upright or sitting may disappear when lying supine.)
*Otherwise healthy individual, no concerns about growth, no symptoms of heart failure such as dyspnea on exertion. (In infants, ask if the baby tires during feeding, becomes diaphoretic, or develops a rapid respiratory rate. In older children, this can be elucidated by asking whether or not the child can keep up with peers during play.)
*Occurs during systole or continuously during both systole and diastole. (Murmurs occurring only during diastole are always pathologic.)
*Physiologic splitting of S2 (A2 and P2 components should only be resolvable during inspiration and should merge during expiration.)
*No palpable thrill (A thrill is a vibration caused by turbulent blood flow.)

Prognosis

Innocent murmurs are inconsequential and usually disappear as the child grows. ECG and Chest XRAY are normal.

Types, description and DDx

LLSB = lower left sternal border

ee also

*Heart murmur
*Precordial examination
*Ventricular septal defect

External links

* [http://www.aafp.org/afp/990800ap/558.html Heart Murmurs in Pediatric Patients: When Do You Refer?] - AAFP


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