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Clinical Applications - Pediatric Murmurs  

 Common condition: Up to 80% of children have a murmur at some point during their childhood; however, less then 1% of these murmurs represent confirmed heart disease. 

A schematic approach to the work-up of a patient with a cardiac murmur according to whether the murmur is probably innocent or secondary to cardiac pathology. This algorithm is particularly relevant to children and adults younger than 40 years, and echocardiography is recommended before cardiac consultation. (from Norton PJ, O'Rourke RA: Approach to the patients with a heart murmur. In Braunwald E, Goldman L  Primary Cardiology. 2nd ed. Philadelphia, Elsevier, 2003 and also ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease (1998).

               S1    Sys.mur          S2       S3                               S1  Sys.mur S2       

                                          

 Innocent Murmur - Early/Mid systolic, grade 2                        Aortic Stenosis - grade 5 murmur,  94 % duration,

 56% duration (low intensity)  => no further workup              Echocardiography evaluation is required

 

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Last modified: 02/02/09