Innocent murmur in early childhood in Uttaradit province

Abstract

ABSTRACT

Background

Heart murmurs are commonly diagnosed among children. Although most of them are primarily innocent murmur on physiologic condition without structural heart defects, it may be the first sign of a structural cardiac disease.  Heart murmur is the sign that should not be ignored since it may cause concerns for both parents and physicians.

Objective

The purpose of this study is to determine the incidence of innocent murmur in healthy early childhood who have heart murmur in Uttaradit province.

Methods

Retrospective review was conducted among healthy early childhood, aged between 1- 6 years old in Uttaradit province. They had been auscultated a heart murmur by pediatricians and further performed an echocardiogram between September 1^st – 30^th, 2018.

Results

According to the study, among 4,100 healthy early childhood (52.4% male), it was found that 38 of them had a heart murmur (0.9%). When further performed an echocardiogram for a definite diagnosis, 36 of them (94.7%) were innocent murmur (52.8% male) with a 4.3±1.5 years on average age, 16.7±5.1 kg on average weight, 101.5±11.4 cm on average height, 0.5±0.3 on average CT ratio. Therefore, overall average data indicated no statistically significant between males and females. The murmurs were systolic ejection murmur grade 2-3/6 and best heard at lower left parasternal border which is the characteristic of an innocent murmur, in Still’s murmur category. Chest X-ray and EKG examination showed normal findings in this group.

Conclusion and discussion

The innocent murmur is commonly found among healthy early childhood. Their heart murmur has a unique sound characteristic. A complete history and physical examination together with an initial chest X-ray and/or EKG examination are sufficient to diagnose an innocent murmur. To this extent, general practitioners should familiarize themselves with listening to innocent murmur in order to reduce unnecessary investigation.

Keywords:  Heart murmur/ Innocent murmur/ Pathological murmur