Official reprint from UpToDate®
www.uptodate.com ©2018 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Overview of common causes of cardiac murmurs in infants and children

Robert L Geggel, MD
Section Editor
David R Fulton, MD
Deputy Editor
Carrie Armsby, MD, MPH


Heart murmurs are common in infants and children. Being able to distinguish a murmur associated with heart disease from a benign etiology is important for diagnosis and management (table 1).

Common causes of heart murmurs in infants and children will be reviewed here. The approach to evaluating cardiac murmurs, identifying newborns with critical heart disease, and evaluating children with suspected heart disease are discussed separately:

(See "Approach to the infant or child with a cardiac murmur".)

(See "Identifying newborns with critical congenital heart disease".)

(See "Suspected heart disease in infants and children: Criteria for referral".)

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:

Subscribers log in here

Literature review current through: Dec 2017. | This topic last updated: Jun 01, 2017.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2018 UpToDate, Inc.
  1. Abdurrahman L, Bockoven JR, Pickoff AS, et al. Pediatric cardiology update: Office-based practice of pediatric cardiology for the primary care provider. Curr Probl Pediatr Adolesc Health Care 2003; 33:318.
  2. Pelech AN. Evaluation of the pediatric patient with a cardiac murmur. Pediatr Clin North Am 1999; 46:167.
  3. McLaren MJ, Lachman AS, Pocock WA, Barlow JB. Innocent murmurs and third heart sounds in Black schoolchildren. Br Heart J 1980; 43:67.
  4. Danford DA, McNamara DG. Innocent murmurs and heart sounds. In: The Science and Practice of Pediatric Cardiology, 2nd ed, Garson AJ, Bricker JT, Fisher DJ, Neish SR (Eds), Williams & Wilkins, Baltimore 1998. p.2204.
  5. FOGEL DH. The innocent systolic murmur in children: a clinical study of its incidence and characteristics. Am Heart J 1960; 59:844.
  6. Bergman AB, Stamm SJ. The morbidity of cardiac nondisease in schoolchildren. N Engl J Med 1967; 276:1008.
  7. Rajakumar K, Weisse M, Rosas A, et al. Comparative study of clinical evaluation of heart murmurs by general pediatricians and pediatric cardiologists. Clin Pediatr (Phila) 1999; 38:511.
  8. Kang G, Xiao J, Wang Y, et al. Prevalence and clinical significance of cardiac murmurs in schoolchildren. Arch Dis Child 2015; 100:1028.
  9. Lang SM, Bolin E, Hardy S, et al. Diagnostic Yield of Outpatient Pediatric Echocardiograms: Impact of Indications and Specialty. Pediatr Cardiol 2017; 38:162.
  10. McCrindle BW, Shaffer KM, Kan JS, et al. Cardinal clinical signs in the differentiation of heart murmurs in children. Arch Pediatr Adolesc Med 1996; 150:169.
  11. Keane JF, Fyler DC. Patent ductus arteriosus. In: Nadas' Pediatric Cardiology, 2nd ed, Keane JF, Lock JE, Fyler DC (Eds), Saunders, Philadelphia 2006. p.617.
  12. Geggel RL. Conditions leading to pediatric cardiology consultation in a tertiary academic hospital. Pediatrics 2004; 114:e409.
  13. Øyen N, Poulsen G, Boyd HA, et al. Recurrence of congenital heart defects in families. Circulation 2009; 120:295.
  14. Marelli AJ, Mackie AS, Ionescu-Ittu R, et al. Congenital heart disease in the general population: changing prevalence and age distribution. Circulation 2007; 115:163.
  15. Geggel RL, Fyler DC. Mitral valve and left atrial lesions. In: Nadas' Pediatric Cardiology, 2nd ed, Keane JF, Lock JE, Fyler DC (Eds), Saunders, Philadelphia 2006. p.697.