Benign paediatric heart murmur

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List of terms related to Benign paediatric heart murmur

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


A benign paediatric heart murmur, also innocent heart murmur or innocent murmur, is an inconsequential sound that originate from the heart and/or cardiovascular system and is heard on cardiac auscultation. By definition, an innocent murmur is not significant in the long-term health of an individual that has it.

Murmurs - innocent versus pathological

Characteristics of innocent murmurs are:

  • Less than 3/6 in intensity, soft
  • Often position-dependent (supine versus upright)
  • Otherwise healthy individual, no concerns about growth
  • Continuous (throughout cardiac cycle) or systolic (diastolic-only sounds are always pathologic)
  • Normal S2 splitting (S2 splitting with inspiration)
  • No palpable thrill (vibration of the chest due to abnormal heart movement/blood flow)

Prognosis

Innocent murmurs are inconsequential and usually disappear as the child grows. ECG and Chest XRAY are normal.

Types, description and DDx

Benign Paediatric Heart Murmurs
Name Location DDx
Still's murmur inferior aspect of LLSB, systolic ejection sound, vibratory/musical quality subaortic stenosis, small VSD
Pulmonary ejection superior aspect of LLSB, ejection sound Pulmonary stenosis, atrial septal defect
Venous hum Infraclavicular throughout the cardiac cycle (right side > left side), diminishes with jugular vein palpation or neck turning PDA
Supraclavicular arterial bruit Above clavicles aortic stenosis, bicuspid aortic valve
Peripheral pulmonary stenosis low-pitch with radiation to back and armpit PDA, pulmonary stenosis

LLSB = lower left sternal border

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