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Innocent murmur — MRCPCH FOP MCQ

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EasyCardiologyInnocent murmurMRCPCH FOP

A 5-year-old boy is seen after a viral illness. He is well, has normal pulses and oxygen saturation, and a soft vibratory systolic murmur at the left sternal edge that disappears on standing. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Innocent Still's murmur

A soft vibratory systolic murmur that changes with posture in a well child is typical of an innocent Still's murmur. Aortic stenosis would more often have an ejection murmur radiating to the neck with possible exertional symptoms. Coarctation would have pulse or blood pressure abnormalities. The pearl is that normal growth, pulses and saturations support a benign diagnosis.

Reference: NICE CKS Heart murmurs in children