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The Innocent Heart Murmur

Hearing your pediatrician say, “Your child has a heart murmur,” can cause instantaneous anxiety. In six simple words your mind envisions heart surgery, failure, and death. It’s amazing how we as parents are programmed to worry whenever we hear that something could be wrong with our child’s heart. The most common heart scenario in childhood is that of the Still’s murmur.

There are tons of terms all used to describe the same type of murmur: stills, physiologic, benign, flow, vibratory, innocent, and functional. Don’t be thrown off if different doctors or people call them different things. They are all the same murmur. For ease, I’ll call them Still’s murmurs.

What are Still’s murmurs?

A murmur is nothing more than a sound heard between the first and second beat of the heart. Normally, there is no sound between the two beats. A Still’s murmur is just one type of murmur. However, if your kid is going to have a murmur, this is the one you want because they are completely benign heart murmurs. They are not associated with any heart disease or disorder. They are very common in childhood (with some sources quoting as many as 1 in 3 children having them at some point). They peak in the 2-7 year-old range, but can happen outside of those ages.

How are Still’s murmurs diagnosed?

Still’s murmurs are diagnosed by an experienced doctor listening with a stethoscope (the term is auscultation). All pediatricians should be well versed in diagnosing Still’s murmurs. The diagnosis does not require fancy electrocardiograms (ECG or EKG) or echocardiograms (echo)–that just causes unnecessary worry and cost. A child with a Still’s murmur shouldn’t need to see a pediatric cardiologist (or heart specialist) either as there isn’t anything wrong with the heart. The sound of the murmur is vibratory or musical in nature. A referral to a specialist or further testing would only be indicated if the sound was atypical in some manner and there was need to rule out something more serious. It is worth noting these benign murmurs are heard more often when kids are going through periods of rapid growth or are sick.

How are Still’s murmurs treated?

Because stills murmurs are nothing more than the heart making a reverberating sound when it is pumping the blood, and there is nothing wrong, there is no need for treatment. There are no medications, no limitations on activities, and no need to worry. The murmur will go away on its own with time (usually by mid-adolescence, if not sooner).

So the next time your doctor says your child has a heart murmur, take a deep breath. There is a good chance that it is no big deal.