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Innocent murmur — RACP Paediatrics MCQ

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EasyCardiologyInnocent murmurRACP Paediatrics

A 4-year-old is referred for assessment of a murmur found incidentally. The murmur is a grade 2/6 low-pitched vibratory systolic murmur at the left lower sternal edge. It varies with position and is louder when supine. The child is well and growing normally. ECG and CXR are normal. What is the most likely diagnosis?

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Correct answer: E — Innocent (Still's) murmur

A vibratory or musical systolic murmur at the left lower sternal edge that varies with position (louder supine) in an asymptomatic child with normal growth and normal ECG/CXR is characteristic of an innocent Still's murmur. This is the most common innocent murmur of childhood.

Reference: RCH Melbourne – 2023 – Heart Murmurs CPG; RACP Paediatric Curriculum – Cardiology