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 ďStillís murmurĒ.
The Stillís murmur was
initially described by
Englandís first professor of childhood medicine.
pediatric textbook Common Disorders and Diseases of Childhood
published in 1909
ďI 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
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.Ē
In fact, no one knows
exactly what causes a Stillís 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 Stillís 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 ďringĒ 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 Stillís murmur is a sign of health, given how generally
healthy the children are who have it.
The Stillís 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 Stillís murmur will come and go over time.
does it mean?
It is very important to understand that the Stillís murmur is
perfectly normal. It
does not suggest any type of heart disorder.
Children with a Stillís 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
Stillís 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 childís heart over the first year of life.
do I tell the grandparents?
An accurate description of a Stillís murmur is to say that your
child has a ďmusical heartĒ.
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!
George Frederick Still (1868-1941)