Cardiac Murmur in a Child

Cardiac Murmur in a Child - Flowchart Cardiac Murmur in a Child Cardiac Murmur in a Child

«Flowchart»

Cardiac murmur

The child is in good health and growth is normal

The child is in good health and growth is normal The child is in good health

The child is seriously ill or syanotic or has cardiac symptoms

The child is seriously ill or syanotic or has cardiac symptoms The child is seriously ill

Referral

End

New appointment in 3 weeks

Most likely a harmless flow sound

Acute infection or the child has recently been physically active

Yes

Yes Yes

No No

The femoral pulses can be palpated
Blood pressure is normal
Blood pressure measured from the lower lib is higher than in the upper lib
The accentuation and splitting of the second heart sound (S2) are normal
The murmur is only heard in systole
The murmur is early systolic or midsystolic ≤3/6°

The femoral pulses can be palpated The femoral pulses can be palpated
Blood pressure is normal Blood pressure is normal
Blood pressure measured from the lower lib is higher than in the upper lib Blood pressure measured from the lower lib is higher than in the upper lib
The accentuation and splitting of the second heart sound (S2) are normal The accentuation and splitting of the second heart sound (S2) are normal
The murmur is only heard in systole The murmur is only heard in systole
The murmur is early systolic or midsystolic ≤3/6° The murmur is early systolic or midsystolic ≤3/6°

Yes

Yes Yes

You are unsure

You are unsure You are unsure

ECG and chest radiograph

Normal

Normal Normal

Abnormal

Abnormal Abnormal

Murmur still present

Yes

Yes Yes

No No