Approaching the child with a heart murmur

Abstract

Children with a heart murmur comprise a great deal of the workload in the pediatric cardiology outpatient clinic, being essencial its diferentiation between an innocent and a pathological murmur. The first identification of the murmur is usually made by the pediatrician, when first examining a child. The characterization of the innocent and pathological murmurs can be done, in most of the patients, without the need of laboratory tests. The most frequent types of innocent murmurs are the vibratory Still’s murmur, the systolic murmur in the pulmonary area and the supraclavicular systolic murmur. The ideal pathological murmur analysis should include its location in the thorax, degree of intensity and the possible ocurrence of aditional sounds. The detailed classification of these murmurs might lead to the establishement of a clinical diagnosis, mainly in those defects considered to be simple in nature.