Heart Murmurs: Innocent or Pathologic

Document Type : Case Report

Authors

Abstract

BACKGROUND:
Many normal children have heart murmurs. Most of these murmurs are innocent but differentiation of innocent murmurs from those due to structural heart disease, pathological murmurs, is important. Some clinicians do not refer the suspected patients to cardiologist due to anxiety-provoking for the family. The aim of this study was to assess the children with heart murmurs who previously their murmurs labeled as an innocent murmur.

METHODS:
During 18 months, 36 children with heart murmur been labeled as innocent were reassessed prospectively as outpatients by a pediatric cardiologist.

FINDINGS:
Overall, 8 different type of congenital heart diseases in 36 patients (17 boys, 19 girls) were diagnosed. The mean age of diagnosis of innocent murmur was at 24 months old. The mean age of detection of congenital heart defects in these patients was 43.5 months old. Physicians referred 80% of patients while 75% of these were referred when were visited by other physicians than their family physicians. About 27% of patients needed medical and surgical attention at diagnosis time.

CONCLUSION:
Although, the diagnosis of innocent murmurs is correct in most of cases, more attention is needed in assessment and clinical examination of suspected children.

KEY WORDS:
Heart murmurs, innocent murmurs, congenital heart disease