medical question: childhood heart murmur

"Morgans" wrote

Agreed, about no fining in adulthood.

Make that no "finding" in adulthood.
--
Jim in NC

On Sun, 7 Aug 2005 03:15:49 -0400, "Morgans"
wrote:


"Ron Rosenfeld" wrote

The OP's description of a possible murmur in infancy; no diagnosis of any
heart disease; no recommended followup; no murmur as an adult; clearly
falls into the "normal finding" category.

Agreed, about no fining in adulthood.

I still stand about saying a heart murmur, until thoroughly diagnosed, is a
heart problem. If it is an abnormal sound compared to a normal healthy
heart is heard, it would have to be investigated. This does not seem to be
the case, but if it was heard at one time, it should be checked. (which it
was)

Your misconception about "heart murmur" is common. But I agree with part
of your statement.

The key phrase you mention is "If it is an abnormal sound ..." As I
implied previously, a heart murmur is not necessarily an "abnormal sound".

Any more than other physical finding, which is not present in all
individuals, is abnormal.

I don't know what you mean by "thoroughly diagnosed" either.

The sequence should be: A competent MD listens to a heart. He notes a
heart murmur. It sounds like a functional murmur. (That term means that
it has no clinical significance and does not imply any kind of heart
problem). He tells patient -- "You have an innocent murmur". That should
be the end of it.

Obviously, if MD1 cannot make that determination, he should refer the
patient to a specialist -- either an adult or pediatric cardiologist -- for
further evaluation. The specialist might choose to perform further
testing; or might make the diagnosis of functional murmur based on his/her
own history and physical.

In my practice, it was not unusual to see patients who were paralyzed with
fear over an innocent heart murmur because of this misconception that it
was necessarily abnormal; and they would often require thousands of dollars
of testing before they would accept the fact that they had no heart problem
-- and sometimes even that was not effective.

This misconception exists amongst physicians, too. Especially
non-cardiologists. But some, I think, are driven to refer their patients
for further testing due to uncertainty; some due to malpractice lawsuit
fears; some for economic benefits; etc.


Ron (EPM) (N5843Q, Mooney M20E) (CP, ASEL, ASES, IA)

Morgans wrote:

I still stand about saying a heart murmur, until thoroughly diagnosed, is a
heart problem.

And I would say that you are confusing a symptom of a possible problem with a
problem. A murmur is a symptom, not a problem.

George Patterson
Give a person a fish and you feed him for a day; teach a person to
use the Internet and he won't bother you for weeks.

"George Patterson" wrote

A murmur is a symptom, not a problem.
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I think this one has been picked (and over picked) to death.

I think it is all is a conspiracy by the Hitler youth.

Is it dead yet? g
--
Jim in NC