PROMPT, accurate diagnosis of heart disease in children has become increasingly important with the advent of more effective therapeutic techniques. For example, corrective surgery holds promise of cure or alleviation of symptoms in a number of congenital malformations of the heart, and more specific therapy is now available for patients with acute rheumatic fever. The use of antibiotics to avoid recurrences of rheumatic fever may represent an even more important contribution, since prevention of disease processes is actually more valuable than treatment of active lesions. Selection of patients for preventative care presents serious problems, since it is neither practical nor desirable to prescribe extended courses of therapy indiscriminately to large masses of the population.
In most pediatric cases, preexisting cardiac disease is initially suspected on the basis of heart murmurs. However, a large proportion of children have murmurs, most of which must be classified as "functional." The murmurs associated with
RUSHMER RF, SPARKMAN DR, POLLEY RFL, et al. VARIABILITY IN DETECTION AND INTERPRETATION OF HEART MURMURS: A Comparison of Auscultation and Stethography. AMA Am J Dis Child. 1952;83(6):740–754. doi:10.1001/archpedi.1952.02040100038003
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