الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
There are two types of heart murmurs: innocent murmurs and abnormal murmurs. A person with an innocent murmur has a normal heart. This type of heart murmur is common in newborns and children.
An abnormal heart murmur is more serious. In children, abnormal murmurs are usually caused by congenital heart disease. In adults, abnormal murmurs are most often due to acquired heart valve problems.
The aim of this work was to assess the incidence and clinical profile of innocent murmur.
This study was an observational prospective study done in Sohag university hospital in the period from Jan 2013 to Jan 2014. It included 183 infant and children with heart murmurs, aged from 6 weeks to 12 years, 97 boys and 86 girls. Patients less than 6 weeks and more than 12 years were excluded from the study.
All the included patients had the following done: Full history, complete systemic examination, cardio vascular examination and Echocardiography.
In our study the result show that innocent murmur represent 53% of all murmurs heard in childhood and the pathological murmurs represent 47%, and the most common structural heart disease causing pathological murmur in order Ventricular septal defect followed by Rheumatic heart disease.
Several healthy children are referred to pediatric cardiologists or for echocardiography. Parental anxiety may also be a reason to refer the patient for unnecessary examinations, and it is important to recognize an innocent murmur as soon as it is found. Auscultation training will naturally improve practitioners’ listening skills.
While there’s not much you can do to prevent a heart murmur, it is reassuring to know that heart murmurs are not a disease and are often harmless. For children, many innocent murmurs go away on their own as they grow. For adults, murmurs may disappear as the underlying condition causing them improves.
Innocent murmurs are very common but it is essential to assess whether the murmur is haemodynamically stable and if there is any doubt, referral to a general pediatricians or pediatric cardiologist is essential.
A patient who has a pathologic cardiac examination or who has cardiac symptoms and questionable findings on the cardiac examination should be referred to a pediatric cardiologist. A child with a malformation syndrome usually associated with congenital heart disease so should be referred for additional evaluation. Conversely, an asymptomatic patient whose physical findings on a conscientiously performed cardiac examination indicate a low probability of cardiac pathology should be followed by the primary care physician. Referral is indicated if possibly pathologic findings emerge on serial examinations.