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The diagnosis of innocent murmurs in childhood
N Advani1, S Menahem, J L Wilkinson
1Department of Cardiology, Royal Children's Hospital, Melbourne, Australia.
Insights
Pediatric cardiologists can accurately diagnose innocent heart murmurs in children. Investigations are often unnecessary for diagnosing innocent murmurs, preventing parental anxiety and unneeded medical procedures.
Area of Science:
- Pediatric Cardiology
- Pediatric Echocardiography
- Pediatric Cardiovascular Health
Background:
- Innocent heart murmurs are common in childhood and require accurate diagnosis.
- Misdiagnosis can lead to unnecessary anxiety and restrictions for children.
- Distinguishing innocent murmurs from pathological ones is crucial.
Purpose of the Study:
- To prospectively evaluate the necessity of investigations in children diagnosed with innocent murmurs.
- To determine if routine investigations are required to exclude organic abnormalities in these cases.
- To reduce unnecessary medical testing and associated parental anxiety.
Main Methods:
- Prospective study of 63 children diagnosed with innocent murmurs by a pediatric cardiologist.
- Review of diagnostic investigations performed to exclude organic abnormalities.
- Focus on the 'Still's' or musical/vibratory murmur type.
Main Results:
- None of the children with innocent murmurs exhibited abnormal investigation results.
- Investigations were found to be largely superfluous for diagnosing innocent murmurs in this cohort.
- Still's murmur was the most common type observed.
Conclusions:
- Routine investigations are generally unnecessary for children with innocent murmurs diagnosed by a pediatric cardiologist.
- Accurate diagnosis by a specialist can prevent unnecessary testing and alleviate parental concerns.
- Further research could explore parental and physician expectations influencing investigation choices.
Abstract:
Innocent murmurs are common in childhood. They require accurate diagnosis to avoid unnecessary anxiety and/or restrictions. With this in mind, we studied prospectively children diagnosed by a paediatric cardiologist as having innocent murmurs to review the necessity of investigations in excluding organic abnormalities. We included 63 children in the study. The majority had the so-called Still's, or musical/vibratory murmur. None had abnormal investigations, suggesting that such investigations are largely superfluous for the purpose of diagnosis in those patients with innocent murmurs seen by a paediatric cardiologist. They are often done, nonetheless, as part of the assessment and/or expectations of the parent or the referring physician.