Patient
Information
Still's Murmur
People often
worry when they hear that their child has a heart murmur.
Happily, most heart murmurs in children are perfectly
normal. One such
murmur is the “Still’s murmur”.
History
The Still’s murmur was
initially described by
Dr.
George
Frederic Still,
England’s first professor of childhood medicine.
In his
pediatric textbook Common Disorders and Diseases of Childhood
published in 1909
Dr. Still
noted:
“I should like to draw attention to a
particular bruit which has somewhat of a musical character, but is
neither of sinister omen nor does it indicate endocarditis of any
sort. …its
characteristic feature is a twangy sound, very like that made by
twanging a piece of tense string...
Whenever may be its origin, I think it is clearly
functional, that is to say, not due to any organic disease of the
heart either congenital or acquired.”
What
Causes It?
In fact, no one knows
exactly what causes a Still’s murmur.
People have looked very closely using ultrasound at the
hearts of children with this murmur, and compared them to the
hearts of children who do not.
No difference has ever been identified.
It is very clear however, that the Still’s murmur is not
caused by any type of heart defect.
Having listened to thousands of children this murmur, my
personal opinion is that young children have very healthy, elastic
hearts that “ring” when they beat, in very much the same way
that a soda bottle makes a musical sound when you blow over the
top. Indeed, I suspect
the Still’s murmur is a sign of health, given how generally
healthy the children are who have it.
Who
has them?
The Still’s murmur may
occur in as many as one third of all children between two and five
years of age. It can,
however, be heard in children ranging in age from newborns to
young adults. Commonly,
a Still’s murmur will come and go over time.
What
does it mean?
It is very important to understand that the Still’s murmur is
perfectly normal. It
does not suggest any type of heart disorder.
Children with a Still’s murmur can play sports just like
any other normal child, and do not require special medical
treatment when they go to the dentist or have other medical
procedures. In fact,
it is perfectly fine not to mention this murmur when one is
filling out forms for insurance companies, school sports
clearance, and dental visits.
Finally, it is not generally necessary for a child with a
Still’s murmur to have additional visits with a cardiologist
unless they are under a year of age, in which case one additional
visit is sometimes recommended just because a lot of changes take
place in a child’s heart over the first year of life.
What
do I tell the grandparents?
An accurate description of a Still’s murmur is to say that your
child has a “musical heart”.
Web
Links
Here are some Internet links that might be helpful. They look pretty good, but I cannot vouch for their
accuracy or quality. As
always with the Internet, browser beware!
American
Heart Association: Innocent Murmurs
http://www.americanheart.org/Heart_and_Stroke_A_Z_Guide/imurm.html
American
Academy of Family Physicians - Heart Murmurs in Children--What
Parents Should Know
http://www.aafp.org/afp/990800ap/990800f.html
iVillage:
Are Infant Heart Murmurs Common?
http://www.homearts.com/depts/health/38docs31.htm
The
Nemours Foundation: Heart
Murmurs
http://kidshealth.org/parent/medical/heart/murmurs.html
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