Navigating heart murmurs in children

Abstract

BACKGROUND: Murmurs are a common finding in the paediatric population, with 99% being non-pathological. Cardiovascular examination is recommended to aid the detection of serious structural cardiac defects as a routine part of neonatal and child health checks. Incidentally noted murmurs are also a common finding, with a significant proportion of children developing an innocent murmur at some stage of childhood. It is therefore important for primary care physicians to be able to appropriately identify concerning features of both screening detected and incidentally noted murmurs in children. OBJECTIVE: The aim of this article is to provide guidance around the assessment of a child with a murmur. DISCUSSION: In the assessment of murmurs, decision making around the level of concern for a pathological murmur and urgency for referral is predominantly based on features other than the murmur itself. Red flags for serious pathology might be obtained through history, examination and preliminary investigations.