The physiology of cardiac auscultation

Cardiac auscultation remains a critical component of the pediatric examination and is the primary method of diagnosis for the common innocent murmurs of childhood. This article outlines the significance of auscultation and defines the skills important for the diagnosis and recognition of common 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 depends the clinician's confidence and experience in recognizing and correctly characterizing these murmurs.