What is Still’s Murmur?
Still’s murmur, also known as an innocent murmur or functional murmur, is the most common benign murmur that impacts one in three children. It refers to a low-pitched, musical sound created by the blood flowing through the heart. Lying on the back facing upward often produces the loudest murmur. However, it is not related to the heart or other health problems.(1) Still’s murmur occurs in the pediatric population between the ages of two to seven years old.(2)
Causes of Still’s Murmur
Blood flowing through the child’s heart generates the sounds of Still’s murmur. However, the exact cause of this murmur is still unknown. Some possible causes of Still’s murmur as suggested by researchers include:
- Fibrous bands or false tendons in the left ventricle might produce a vibrating noise with blood flow.
- Thing, strong chords connected to the tricuspid valve inserted into blood flow from the right ventricle.
- Vibrations caused by blood flowing through the child’s heart chambers.
Symptoms of Still’s Murmur
The primary symptom of Still’s murmur is a soft musical vibration, which could sound like an Aeolian harp (a string instrument played by the wind). The murmur can be heard by your child’s doctor with the help of a stethoscope.
Still’s murmur seems to be louder when the child lies down with their face up and it gets softer when they sit or stand up. The murmur can come and go at different times. When children fall sick or are excited, Still’s murmur can be louder.
Is There Anything to Worry About It?
Still’s murmur is the most common heart murmur in children. Although many children have Still’s murmur, there is nothing to worry about the condition as it often goes away completely before adolescence without any treatment. There is no danger to the children’s health from Still’s murmur.
However, parents are often anxious when told their child has a heart murmur and might experience significantly greater anxiety than the children themselves. According to a study conducted on the families impacted by Still’s murmur, it was found that the parents were worried about a lot of issues. After hearing from an expert cardiologist that the children would be fine and that there was nothing wrong with them, only 7% of the parents were still nervous.(3)
Diagnosis For Still’s Murmur
Your child’s doctor will first ask about the child’s medical history and then go for a physical examination when they check their blood pressure, abdomen (to check for a heart failure or an enlarged liver), oxygen levels, and pulses in your child’s feet to check blood flow.
Apart from these, using a stethoscope, the doctor will also listen to the internal sounds of your child’s body. If they hear a heart murmur, they will monitor:
- Whether the murmur changes with movements. With Still’s murmur, the sound is loudest when children are lying down.
- Whether they can hear the murmur in only a single place or different places (radiation). Still’s murmur has no radiation.
- Location of the heart’s murmur. Still’s murmur primarily comes from the lower-left area of the sternum.
- Softness or loudness of the murmur (intensity). A soft sound is produced with Still’s murmur.
- The sound or quality of the murmur and its pitch. Still’s murmur has a musical, low-pitched sound.
If the doctor diagnoses Still’s murmur, no further test or treatment is required. However, if your healthcare provider suspects a non-innocent heart murmur then they might refer your child to a cardiologist for further testing, which might include an echocardiogram (echo) and electrocardiogram (ECG)
Treatment For Still’s Murmur
There is nothing to worry about Still’s murmur and children with this condition do not require any treatment. Usually, it goes away over time. There are no complications associated with this condition as there is nothing wrong with the heart. Children with Still’s murmur can live a normal life and can continue to exercise, play, go to school, and do their normal day-to-day activities. So, children with Still’s murmur can lead a fully normal life with absolutely no limitations.
Conclusion
Still’s murmur is a common heart murmur, also known as an innocent murmur that is generally seen in children between ages of two to seven years. This condition is not related to any heart problem or any other health condition and there is nothing to worry about it. Children with Still’s murmur can lead a normal life without the need for any treatment. However, if you are concerned about your child having Still’s murmur, then consult with your child’s pediatrician and take their advice.
