Managing a “New” Murmur in Healthy Children and Teens

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An asymptomatic child with a murmur can be challenging practice management conundrum. Some providers refer all patients with a “new” murmur to a cardiologist, likely resulting in excessive resource utilization and parental anxiety. This study examines whether the prevalence of significant cardiac pathology differs in asymptomatic patients aged 2 to 18 years who were referred for a murmur that was “new” versus those referred for a murmur that was known to exist and followed conservatively during the previous 2 years. Of 473 patients meeting inclusion criteria, 33/473 (7.0%) were diagnosed with cardiac pathology, with 21/357 (5.9%) occurring among “new” murmur referrals and 12/116 (10.3%) occurring among “known” murmur referrals. Notably, 34/357 (9.5%) patients referred for a “new” murmur had no murmur present when assessed by the cardiologist. This study suggests that asymptomatic children with a “new” murmur may be conservatively managed. This may lessen health care resource utilization rates and overall parental anxiety.

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