The cardiac murmur. When to refer?

This review article outlines the significance and defines the skills important for the diagnosis and recognition of common innocent cardiac murmurs in childhood. The origin of heart sounds and murmurs is reviewed, and an approach to pediatric murmur evaluation is presented. The seven innocent murmurs of childhood and adolescence are reviewed in detail. Further diagnostic evaluation and referral is dependent on the comfort factor and experience in recognition and correct characterization of these murmurs.