THE INNOCENT(FUNCTIONAL) CARDIAC MURMUR IN CHILDREN

[摘要] THE DEVELOPMENT of modern cardiac surgical techniques is one of the great milestones in medicine. Its ramifications have been wide and deep. In its wake of many curative and palliative procedures for congenital and acquired heart disease, there is a renewed interest in the significance of the cardiac murmur. In former years the murmur was merely noted. Today, it is pursued until its etiology is firmly established with the hope that the final investigation will lead to remedial or palliative surgery. Many times the murmur turns out to be a functional one. This has prompted the physician to pose questions concerning the incidence and characteristics of the innocent or functional systolic murmur, especially in children. The answer is not readily obtained.REVIEW OF THE LITERATUREThe accepted definition1 has been listed as, "Innocent (functional) murmurs are usually systolic in time, more often faint than of moderate intensity and usually blowing in quality. They are often inconstant and vary in intensity with change in posture. The commonest is a systolic murmur at the pulmonic area, which is usually best heard with the patient supine and during expiration. An apical systolic murmur is also common. Such murmurs are unaccompanied by any evidence of structural disease such as an enlargement of the heart, abnormal cardiac silhouette on roentgenologic examination or an abnormal electrocardiogram." It is the author's opinion that this general definition is not specifically descriptive for children; the commonest functional murmur in children is not located in the pulmonic area, it is not blowing, and further, an innocent apical systolic murmur is uncommon.

[学科分类] 儿科学