Approach to the child with murmur

Abstract

Heart murmur is a common finding in children. Fortunately, most of these murmurs are innocent murmurs. Innocent murmurs can be detected in 70-85% of healthy children. In contrast, the incidence of congenital heart disease is 0.8% and acquired heart disease is rare in children. Therefore, distinguishing innocent from pathologic murmur is a frequent and an important task for the physician. Heart murmurs of children can usually be diagnosed through a careful history and physical examination. If an abnormality is detected; electrocardiogram, telecardiogram and echocardigram should be ordered to diagnose the cause of the murmur. In this report, the features of murmurs, innocent murmurs, how to evalute a murmur, use of laboratory studies in diagnosis and management of a child with a murmur were reviewed. (Turk Arch Ped 2009; 44: 48-52)