Abstract
Heart murmur is the most common reason for a referral to a pediatric cardiologist. Virtually all children have a heart murmur during their childhood. Less than 1% of murmurs are pathological in children. Innocent/functional heart murmur is the most common type of heart murmur. There are multiple theories proposed to identify etiology of innocent heart murmur with varying consensus, but everybody agrees that innocent heart murmur does not carry any morbidity or mortality risk. Even today, heart murmur is associated with high physician uncertainty and parental anxiety. Extensive cardiac evaluation for such a benign finding is also associated with high health care utilization and cost. This article attempts to review this long-known finding which continues to remain a diagnostic challenge.
Highlights
BackgroundCardiac murmurs have remained a “hot topic” in cardiac evaluation since the invention of the stethoscope by Rene Laennec in the early 17th century [1]
Less than 1% of pediatric heart murmurs are associated with congenital heart disease, and most of the heart murmurs are innocent in nature [3]
Pulmonary flow murmur: This is a harsh quality, grade 2-3, medium-high pitched, ejection systolic murmur. This murmur is best heard with the diaphragm of a stethoscope
Summary
Cardiac murmurs have remained a “hot topic” in cardiac evaluation since the invention of the stethoscope by Rene Laennec in the early 17th century [1]. Pulmonary flow murmur: This is a harsh quality, grade 2-3, medium-high pitched, ejection systolic murmur This murmur is best heard with the diaphragm of a stethoscope. Supraclavicular systemic flow murmur: This is a harsh quality, crescendo-decrescendo, medium-high pitched, grade 2-3 murmur heard over the supraclavicular region with radiation to the carotids This murmur is best heard with the diaphragm of a stethoscope and can be present in any pediatric age group as well as young adults. There are a few commercially available softwares in the market designed to aid with determining pathological nature of a heart murmur [24] These softwares have improved significantly over time but they still lag high specificity and sensitivity for making an accurate diagnosis consistently. For the time being they are not ready for routine use in author’s opinion
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