Investigation of Pediatric Innocent Murmur with Echocardiography

Abstract

Abstract Introduction: Innocent murmurs are common in childhood. Usually, they are heard without any structural and physiological abnormalities. The murmur is usually weak and short. But even if it is thought to be innocent, echocardiography (ECHO) is occasionally requested by primary doctor or families. The aim of this study is evaluation of childhood innocent murmur with ECHO and possible minor findings with normal clinical status. Method: This is a descriptive - retrospective chart review. We reviewed the charts of children and adolescents who were referred with asymptomatic murmur to Pediatric cardiology clinic at Fatih University Hospital between 01/ 2010 – 12/2011. We excluded cases who are found with any type of congenital/acquired cardiac diseases. Due to the nature of this study, we only included first to third degrees of murmurs. All participants are analyzed based on demographic, clinical, and ECHO finding data. Results: We reviewed 610 charts. 115 cases (18%) were excluded. 495 cases (82%) were included in the study. 209 (42.2%) of them were female and 286 (57.7%) were male. Age range was between 1 and 202 months (52,2 ± 41,9), height was between 50 and 175cm (102,2 ± 28,8) and body weight was between 3.70 and 97kgs (18,8 ± 12,89). Minimal Tricuspid valve regurgitation (TVR) was seen in 200 children (40.4%) and minimal TVR+ physiological Mitral valve regurgitation (MVR) was seen in 65 children (11.6%). Patent foramen ovale (PFO) was seen in 306 children (54,8%). Left ventricular (LV) muscular band (false tendon) was seen in 171 children (30,6%). Minimal TVR + physiological MVR+ LV muscular band (false tendon) was seen in 26 children (4,7%), trivial arteria valve regurgitation (AVR) was seen in 7 children (1,4%), and minimal TVR + minimal pulmonary regurgitation (PR) was seen in 11 cases (2%). Discussion: Even though the nature of murmur in physical exam supports the diagnosis of innocent murmur, evaluation with ECHO is commonly requested by families and physicians. In our study we excluded 18% of cases due to the presence of primary cardiac diseases. Included cases also exhibited some cardiac findings but none of those cause any shown cardiac dysfunction in near future. We advise innocent murmur group to be followed by primary physician unless they have any cardiac symptoms.

Keywords

• innocent murmur
• echocardiography
• pediatric

References

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