Innocent Murmurs

These are also known as Flow murmurs, and they're common in children as they have very fast, turbulent blood flow.

N.B. It's important to note that these are called innocent murmurs for a reason. They're not pathological, but instead physiological.

Features - 5 F's:

• Soft

• Short

• Systolic – all diastolic murmurs are pathological

• Symptomless

• Situation-dependent – quieter on standing, or comes on with illness

When taking the history, it's important to ask about if the patient has a concurrent illness. This is important as:

• If the murmur is made more prominent during the illness, it's best to review it once child has recovered

• If the murmur resolves with the illness, it’s in keeping with an innocent murmur

The murmur should be investigated promptly if it's Loud, Diastolic, Louder on standing, or Symptomatic (failure to thrive, difficulty feeding, cyanosis, increased WOB). Investigations would include an ECG, Echo, and CXR.