Research on common causes of heart murmurs in children

Chen Li; Jiao Meng; Jin Mei

doi:10.3760/j.issn.1673-4777.2019.08.005

Abstract：Objective To explore the common causes of heart murmurs in children.Methods One hundred and six children with heart murmurs,including 48 males (45.3％) and 58 females (54.7％),with a median age of 8 months(quartile 1 month,2.08 years;range 4 d-13.75 years) who visited Beijing Anzhen Hospital,Capital Medical University from September 2018 to January 2019 were included.General data,medical history,physical examination,auscultation findings (heart murmurs) and results of echocardiography were analyzed.Results Heart murmurs were found at 2-3 or 3-4 intercostals of left sternal margin in 82 cases(77.4％);the rest was found at the apex of the heart.Heart murmur loudness was grade 1 in 56 cases(52.8％),grade 2-3 in 43 cases(40.6％) and grade 3 in 7 cases(6.6％).Most murmurs were limited and non-conductive.Echocardiography examination showed 28 cases(26.4％) of congenital heart disease(CHD),including 6 cases of atrial septal defect,16 cases of ventricular septal defect,5 cases of mild pulmonary valve stenosis and 1 case of single ventricle (type B) with transposition of the great arteries.Prevalence of CHD in children with murmur loudness grade 3 and grade 2-3 was significantly higher than that in children with murmur loudness grade 1 [100.0％ (7/7),37.2％(16/43) vs 8.9％ (5/56)] (x2 =30.887,P ＜0.001).Prevalence of CHD in children with age≤6 months was 38.0％ (19/50),which was significantly higher than that in children with age ＞6 months[16.1％ (9/56)] (x2 =6.535,P =0.011).Conclusions Heart murmurs with loudness grade 1 and heart murmurs in children over 6 months old are more likely to be physiological murmurs.Heart murmurs with loudness grade 2 or above and heart murmurs in young children(≤6 months old) may indicate high possibility of CHD.