Innocent murmurs in pediatrics
Villavicencio, R.
Boletin de la Asociacion Medica de Puerto Rico 73(10): 479-487
1981
ISSN/ISBN: 0004-4849 PMID: 6950725 Document Number: 701170
The presence of a heart murmur does not alway imply associated heart disease. Heart murmurs can be found in many normal, asymptomatic children. They are very frequent, and sometimes their differentiation from those heard in cardiopathies is a difficult task. The most frequent types of innocent murmurs in children are discussed so that they can be properly identified. They are: 1) the classical vibratory murmur (Still's murmur): 2) the pulmonary flow murmur: 3) the venous hum, and 4) the carotid bruit. Other extracardiac conditions which can cause innocent murmurs are: the straight back syndrome, anemia (hemic murmur) and the cardiorespiratory murmur. In the presence of an innocent murmur, even if the patient is asymptomatic, the following recommendations are advised: 1. Notify the parents about the finding. 2. Repeat the physical exam with an ECG and a chamber analvsis. 3. Pediatric cardiology evaluation if the murmur persists, and any of the aboye tests are not normal. 4. Do an echocardiogram if a definite diagnosis cannot be attained by clinical means. 5. Assure the parents that heart disease is not present, that no restrictions are needed, that the murmur will probably fade gradually and, aboye of all, that the child has a normal heart.
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