Functional murmur

A functional murmur (innocent murmur, physiologic murmur) is a heart murmur that is primarily due to physiologic conditions outside the heart, as opposed to structural defects in the heart itself.[1]

Serious conditions can arise even in the absence of a primary heart defect, and it is possible for peripheral conditions to generate abnormalities in the heart. Therefore, caution should be applied to use of the terms "innocent" or "benign" in this context.

Use of the term dates to the mid 19th century.[2]

Benign pediatric heart murmur

Functional murmurs are an important consideration in the precordial examination of an infant or child.

Characteristics

Prognosis

Innocent murmurs are inconsequential[4] and usually disappear as the child grows. ECG and Chest XRAY are normal.

Types, description and DDx

Benign Paediatric Heart Murmurs
Name Location DDx
Still's murmur[5] inferior aspect of LLSB (lower left sternal border), systolic ejection sound, vibratory/musical quality subaortic stenosis, small VSD
Pulmonary ejection superior aspect of LLSB, ejection sound Pulmonary stenosis, atrial septal defect
Venous hum Infraclavicular throughout the cardiac cycle (right side > left side), diminishes with jugular vein palpation or neck turning PDA
Supraclavicular arterial bruit (Systemic Flow Murmur) Above clavicles aortic stenosis, bicuspid aortic valve
Peripheral pulmonary stenosis (Pulmonary flow murmur) High-pitch with radiation to back and armpit PDA, pulmonary stenosis

In the adult, hyperdynamic circulation of the blood may also produce a functional murmur, such in anemia or thyrotoxicosis.

See also

References

  1. "functional murmur" at Dorland's Medical Dictionary
  2. LUISADA AA (May 1955). "The functional murmur: the laying to rest of a ghost". Dis Chest. 27 (5): 579–81. PMID 14365576.
  3. Thomas Biancaniello. Innocent Murmurs Circulation. 2005; 111: e20-e22.
  4. "Innocent Heart Murmurs". Retrieved Jan 11, 2016.
  5. Joffe HS (February 1992). "Genesis of Still's innocent systolic murmur". Br Heart J. 67 (2): 206. doi:10.1136/hrt.67.2.206-b. PMC 1024759Freely accessible. PMID 1540448.

5. Circulation 2005: Innocent Murmurs http://circ.ahajournals.org/cgi/content/full/111/3/e20

External links

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