[Cardiologic findings in incidental heart sounds in childhood]

In a random sample of patients examined in the outpatient department of pediatric cardiology in Giessen, an innocent heart murmur was found in 1009 children. Results and methods of cardiological examination relevant to the practitioner were established by evaluating the individual diagnostic criteria. An anamnesis without any reference to heart disease is of special significance for the diagnosis of an innocent heart murmur. Another important factor is the experience of the examining doctor. Innocent murmurs are systolic and frequently of "musical quality", their intensity ranges from grade 1/6 to grade 3/6 (95.5%) and is greatest when the patient is supine (76%). Phonocardiography and the Amylnitrit-Test can give important hints. The electrocardiogram should be inconspicuous in terms of age. X-Ray and echocardiogram should be normal, but are not always necessary. Several examinations may be required to established a clear diagnosis. A diagnosis of an innocent heart murmur in children is possible in the practitioner's office, provided the doctor is familiar with the above mentioned criteria.