Phono-spectrographic analysis of heart murmur in children

Anna-Leena Noponen; Sakari Lukkarinen; Anna Angerla; Raimo Sepponen
January 2007
BMC Pediatrics;2007, Vol. 7, p23
Academic Journal
Background: More than 90% of heart murmurs in children are innocent. Frequently the skills of the first examiner are not adequate to differentiate between innocent and pathological murmurs. Our goal was to evaluate the value of a simple and low-cost phonocardiographic recording and analysis system in determining the characteristic features of heart murmurs in children and in distinguishing innocent systolic murmurs from pathological. Methods: The system consisting of an electronic stethoscope and a multimedia laptop computer was used for the recording, monitoring and analysis of auscultation findings. The recorded sounds were examined graphically and numerically using combined phono-spectrograms. The data consisted of heart sound recordings from 807 pediatric patients, including 88 normal cases without any murmur, 447 innocent murmurs and 272 pathological murmurs. The phono-spectrographic features of heart murmurs were examined visually and numerically. From this database, 50 innocent vibratory murmurs, 25 innocent ejection murmurs and 50 easily confusable, mildly pathological systolic murmurs were selected to test whether quantitative phono-spectrographic analysis could be used as an accurate screening tool for systolic heart murmurs in children. Results: The phono-spectrograms of the most common innocent and pathological murmurs were presented as examples of the whole data set. Typically, innocent murmurs had lower frequencies (below 200 Hz) and a frequency spectrum with a more harmonic structure than pathological cases. Quantitative analysis revealed no significant differences in the duration of S1 and S2 or loudness of systolic murmurs between the pathological and physiological systolic murmurs. However, the pathological murmurs included both lower and higher frequencies than the physiological ones (p < 0.001 for both low and high frequency limits). If the systolic murmur contained intensive frequency components of over 200 Hz, or its length accounted for over 80 % of the whole systolic duration, it was considered pathological. Using these criteria, 90 % specificity and 91 % sensitivity in screening were achieved. Conclusion: Phono-spectrographic analysis improves the accuracy of primary heart murmur evaluation and educates inexperienced listener. Using simple quantitative criterias a level of pediatric cardiologist is easily achieved in screening heart murmurs in children.


Related Articles

  • THE ASYMPTOMATIC CHILD WITH A HEART MURMUR. Franklin, Rodney; Slavik, Zdenek // Pulse;5/7/2008, Vol. 68 Issue 16, p36 

    The article presents a case of the asymptomatic child with a heart murmur which is the most frequent paediatric cardiology problem. According to a report, up to 90% of children if carefully screened will be found to have a murmur at some point during their development. The author also presented...

  • Small Atrial Septal Defect associated with Physiologic Splitting of the Second Heart Sound. Pilapil, Virgilio R.; Zipes, Douglas P. // Clinical Pediatrics;Jan1971, Vol. 10 Issue 1, p18 

    This article focuses on two patients who underwent cardiac catheterization to establish the diagnosis. A 12-year old girl was examined for a heart murmur detected during a routine school screening by phonocardioscan. A grade II/VI systolic ejection murmur was noted at the second left...

  • The Innocent (Functional) Cardiac Murmurs of Childhood. Friedman, Sidney // Clinical Pediatrics;Feb1965, Vol. 4 Issue 2, p77 

    The article deals with innocent cardiac murmurs. It have been estimated to be present in 20 to 40 per cent of healthy children. Two main categories of such benign murmurs are recognized: the mid-precordial musical murmur or the twanging-string murmur of Still and the ejection type of basal...

  • Murmurs, fainting, chest pain: Time for a cardiology referral? Brumund, Michael R.; Strong, William B. // Contemporary Pediatrics;Mar2002, Vol. 19 Issue 3, p155 

    Reviews findings in the history and physical examination of children with murmurs, chest pain and syncope that suggest an underlying cardiac abnormality. Association between murmurs and structural heart disease; Characteristics of a murmur; Most common causes of pathologic heart murmurs.

  • Do Parents Need to Know More About Innocent Murmurs? Scanlon, John W. // Clinical Pediatrics;Jan1971, Vol. 10 Issue 1, p23 

    This article attempts to discover what parents want to know about heart murmurs in their child and what they actually do understand. In the initial survey, 78 per cent of the parents did not know what a murmur was. Thirty-five per cent thought a murmur was a rhythm disturbance and 20 per cent...

  • Heartening news. Lee, Michelle // Baby Talk;Sep2002, Vol. 67 Issue 7, p16 

    Presents information on heart murmur among babies. Symptoms; Diagnosis; Causes; Treatment.

  • Dr. Computer Checks for Dangerous Heart Murmurs.  // Prevention;Jan2002, Vol. 54 Issue 1, p112 

    Discusses the development of a computer-driven detection system that can distinguish serious heart murmurs from healthy heart sounds in children.

  • Some Thoughts About Functional or Innocent Murmurs. Friedman, Sidney // Clinical Pediatrics;Dec1973, Vol. 12 Issue 12, p678 

    Discusses the issues about functional or innocent heart murmurs in children. Congenital heart disease and rheumatic heart disease; Importance of the proper analysis and interpretation of the murmurs produced; Negative effects of misinterpreting a functional murmur as a heart disease; Advice to...

  • Heart murmurs.  // Pediatrics for Parents;1998, Vol. 18 Issue 2, p11 

    Explains the possible causes of heart murmurs in children. Percentage of children who may have a heart murmur at some time during their lives; Signs that may indicate a pathologic murmur; Congestive heart failure as a sign of a pathologic heart murmur; Importance of proper diagnosis.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics