Evaluation of children with heart murmurs

Most of the murmurs that are detected in children between the ages of 6 months and 15 years are of the innocent type. Given the high prevalence of murmurs in this population coupled with the low occurrence of congenital heart disease, distinguishing innocent from pathologic murmur is a frequent and important task for the primary care clinician. The primary care clinician can develop the necessary skills to distinguish between the innocent heart murmurs and pathologic murmurs using history and physical examination skills. Becoming familiar with the characteristics of the five most common innocent heart murmurs, which are (1) vibratory or Still's murmur, (2) pulmonary flow murmur, (3) peripheral pulmonary artery stenosis murmur, (4) supraclavicular arterial bruit murmur, and (5) venous hum, will assist the primary care clinician in accomplishing this task in a competent and cost-effective manner.