title: Managing a "New" Murmur in Healthy Children and Teens.
abstract: 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.
authors.affiliation: 1 Walter Reed National Military Medical Center, Bethesda, MD, USA.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Gupta
authors.affiliation: 1 Walter Reed National Military Medical Center, Bethesda, MD, USA.
authors.forename: Joseph W
authors.initials: JW
authors.lastname: May
mesh_terms: D000293:Adolescent; D000072096:Cardiologists / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006337:Heart Murmurs / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D010372:Pediatrics / Q000379:methods*; D012017:Referral and Consultation / Q000706:statistics & numerical data*
keywords: congenital heart disease; murmur; pediatric; resource utilization