Murmurs

Innocent murmurs

1) Pulmonary Flow Murmur

Infants

• Commonly heard in infancy, especially in premature infants, and characterized as soft (grade I or II), mid systolic, and heard best along the left upper sternal border.
• Murmur should disappear by 6 months
• Persistence after 6 months warrants referral for evaluation of underlying structural disease, such as atrial septal defect.

Children

• Can be transiently seen in states of increased hemodynamics, such as exercise, fever, or anemia.
• Should disappear when cardiac output normalizes.

2) Still's murmur

References

1) https://publications.aap.org/pediatricsinreview/article/42/7/375/179821/Cardiac-Examination-and-Evaluation-of-Murmurs