The diagnostic importance of murmurs audible on the back in children with heart disease

De Beer H. ; Petrie A. ; Kalis N.N. ; Van Der Merwe P.-L. (1999)


Murmurs heard over the back in children with heart disease are usually thought to be caused by pulmonary stenosis and coarctation of the aorta. In this prospective study 59.6% of 104 children with various congenital and acquired heart defects were found to have an audible murmur over the back. An audible murmur over the back of a child with a ventricular septal defect was indicative of either a very small ventricular septal defect or an accompanying underlying cardiac lesion. In children with ventricular septal defect and/or mitral incompetence, auscultation over the back contributed towards making a more accurate clinical and/or anatomical diagnosis. A child with mitral incompetence and an audible murmur over the back will have a grade 2 or more echocardiographic evaluated valve lesion. It is concluded that the presence of a murmur over the back rarely contributes to the final diagnosis but may be indicative of the severity of the underlying lesion.

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