title: [Functional heart murmur and echocardiography: a solved problem?].
abstract: BACKGROUND
  Is it really vanished the need for echocardiography in the differential diagnosis of functional pediatric murmurs?
  
  
  METHODS
  To this aim 260 children (132 males, 128 females; age range 1-84 months) were examined with auscultatory cardiac murmur. All children underwent a clinical and instrumental evaluation (ECG and echocardiography) from two pediatric cardiologists with independent assessment.
  
  
  RESULTS
  Two hundred and ten patients (Group A) were evaluated clinically with functional murmur, 45 patients (Group B) with pathological murmur, 5 patients (Group C) with uncertain pathology. ECG showed changes in 1 Group B patient. Echocardiography showed pathology in 15 Group A patients (6 patients with patent foramen ovale, 5 patients with interatrial defect, 2 patients with bicuspid aortic valve, 1 patient with mitral insufficiency, 1 patient with restrictive cardiomyopathy). Pathology was excluded in 3 Group B patients, and in 2 Group C patients. In our clinical analysis echocardiography showed sensitivity 75%, specificity 97%, positive predictive value 90%, and negative predictive value 92%.
  
  
  CONCLUSIONS
  In our experience we suggest to perform echocardiographic examination in children with functional murmur for complete assessment.
authors.affiliation: Divisione di Medicina Interna PO. Rogliano, Azienda Ospedaliera, Cosenza.
authors.forename: M T
authors.initials: MT
authors.lastname: Manes
authors.forename: C
authors.initials: C
authors.lastname: Pintaudi
authors.forename: M
authors.initials: M
authors.lastname: Balsano
authors.forename: M
authors.initials: M
authors.lastname: Giglio
authors.forename: F
authors.initials: F
authors.lastname: Plastina
authors.forename: F
authors.initials: F
authors.lastname: Russo
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006337:Heart Murmurs / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014463:Ultrasonography
vernacular_title: Soffio cardiaco funzionale ed ecocardiografia: un problema risolto?