top of page

PASSRACGP Logo_white.png

Progress

0%

Cardiovascular

Abdominal pain in kids

Abnormal/Dysfunctional Uterine Bleeding (AUB/DUB)

Acanthosis Nigricans

Actinic Cheilitis

Acute Kidney Injury (AKI)

Acute Swollen Joint with Fever

Acute Vision Loss

Acute and Progressive Vision Loss

Adjustment Disorder and Anxiety

Adjustment Disorder with Depressed Mood

Age related macular degeneration

Alcohol Cessation

Allergic rhinitis

Angular Cheilitis

Ankylosing Spondylitis (AS)

Anorexia Nervosa

Anticholinergics and TCAs

Antidepressants

Antimetabolite drugs

Antiphospholipid syndrome

Anxiety Disorders

Aortic Dissection

Atrial Fibrillation

Behavioural / learning disorders

Behavioural disturbances

Bell’s palsy and Ramsey Hunt syndrome

Beta-Human Chorionic Gonadotropin (β-hCG)

Biologic agents

Bipolar Disorder

Bleeding disorders

Bronchiectasis (Updated)

CA-125 (Cancer Antigen 125)

CVD Risk Assessment

Calluses and Corns

Candida (Candidiasis as an STI)

Carpal tunnel syndrome and de quervains tenosynovitis

Cervical spondylosis

Chickenpox (Varicella)

Chronic Cough in Children

Chronic Fatigue Syndrome (CFS)

Chronic Kidney Disease (CKD)

Chronic Rhinosinusitis

Chronic Stridor

Clavicular fracture

Colorectal Cancer Screening Recommendations

Congestive Cardiac Failure

Connective Tissue Diseases

Contact Dermatitis

Cutaneous Drug Eruptions

Dacrocystitis, dacyrostenosis, dacyrocystocoele

Deep Vein Thrombosis (DVT)

Depression and Delirium

Dermal melanocystosis (mongolian spot)

Developmental Dysplasia of the Hip (DDH)

Diabetes Insipidus (DI) vs Primary Polydipsia

Diabetic Neuropathy

Dizziness / syncope

Duchenne muscular dystrophy

Dupuytrens / trigger finger

Dyspnoea (Shortness of Breath)

Innocent Murmur

Definition

Non-pathological heart murmur in healthy children, unrelated to structural heart disease

____________________________________

Symptoms

Asymptomatic with no cyanosis, syncope, failure to thrive, or dyspnoea

____________________________________

Diagnosis: 7 S’s

Sensitive: Changes with position or respiration (softer when standing)
Short: Brief systolic murmur
Single: No extra heart sounds (e.g., clicks, gallops)
Small: Localised with no radiation
Soft: Low intensity (grade 1–3/6)
Sweet: Soft, blowing quality
Systolic: Ejection murmur with no diastolic component

____________________________________

Negative Indicators

Cyanosis, tachypnoea, tachycardia, oedema, or fatigue
Abnormal growth or weight gain
Heaves, thrills, diastolic murmur, or other abnormal findings
Rare in infants <1 year, requiring evaluation for congenital heart disease

____________________________________

Management

Reassurance: Educate parents on the benign nature of the murmur
Follow-up: Routine reviews to monitor for any changes

____________________________________

When to Refer

Concerning signs such as failure to thrive, cyanosis, syncope, or exertional symptoms
Persistent murmur despite positional changes
Features not fitting the 7 S’s
Referral to a paediatric cardiologist for echocardiography

Innocent Murmur

Definition

Harmless heart murmur found in healthy children with no underlying structural heart disease
Also known as a functional or physiologic murmur
Most confidently diagnosed in children over 1 year of age

____________________________________

Symptoms

Typically asymptomatic with no cyanosis, syncope, failure to thrive, or dyspnoea
Detected incidentally during routine cardiovascular examination

____________________________________

Diagnosis

Based on the "7 S’s":
- Sensitive: Murmur intensity changes with position or respiration (softer when standing)
- Short: Brief, confined to early or mid-systole
- Single: No additional heart sounds such as clicks or gallops
- Small: Localised with no radiation to other areas
- Soft: Low intensity, usually grade 1–3/6
- Sweet: Soft, blowing or musical quality
- Systolic: Present only during systole with no diastolic component
Absence of abnormal findings on general and systemic examination
Evaluate cautiously in infants under 1 year due to higher risk of congenital heart disease

____________________________________

Management

Provide reassurance that the murmur is benign and expected to resolve with growth
Routine follow-up during regular health checks to monitor for any new symptoms or changes
No specific treatment required for an innocent murmur

____________________________________

When to Refer

If there are signs such as failure to thrive, cyanosis, syncope, or exertional dyspnoea
If the murmur persists without variation on positional changes or exhibits features inconsistent with the 7 S’s
Referral to a paediatric cardiologist for echocardiography if any risk factors or abnormal findings are present

____________________________________

Notes

Innocent murmurs are common in children and generally have no long-term consequences
A comprehensive history and physical examination are essential to rule out pathological murmurs
Parental education is crucial to alleviate concerns and encourage routine monitoring

Bookmark Failed!

Bookmark Saved!

bottom of page