排除标准 Exclusion Criteria

• 患者2岁或者2岁以下
• 患者具有症状
• 检查期间患者不配合

定义杂音类型 Definition of Type of Murmurs

• Still's murmur:a low-frequency systolic murmur less than or equal to grade 3/6 in intensity; heard best along left sternal border; normal second heart sound; no click; no diastolic murmur.
• Pulmonic flow murmur: a mid-frequency murmur less than or equal to grade 3/6 in intensity; heard best at upper left sternal border; normal second heart sound; no click; no diastolic murmur.
• Venous hum: a high-frequency murmur of grade 3/6 or less in intensity; best heard in sitting or standing position; best heard at base of the neck or the infraclavicular or supraclavicular area; normal second heart sound; systolic and/or diastolic in timing; abolished by compression of jugular vein, change of head position, or assumption of supine position.
• Carotid bruit: grade 3/6 or less in intensity; heard over carotid artery; no associated precordial ejection click; no clinical evidence for aortic stenosis; no diastolic murmur; normal second heart sound.

临床协议说明

(英文原文)This algorithm is intended to address the evaluation of the innocent murmur of childhood. Since "Time 0" is the initial evaluation by a pediatric cardiologist, the murmur will not have been classified as innocent. Hence, the algorithm is directed at the evaluation of a systolic murmur in an asymptomatic child 2 years of age or older. While many pediatric cardiologists are comfortable diagnosing an innocent murmur on the basis of the history and physical examination alone, some pediatric cardiologists obtain a chest radiogram and/or electrocardiogram. Thus, an ECG and a chest radiogram have been designated as Class II tests at the time of the initial evaluation. Because there are cases for which the history and physical findings are atypical for an innocent murmur, the algorithm provides for echocardiography* in selected cases. Once a murmur is determined to be innocent, further cardiac evaluation is unnecessary.