Distinguishing Between Innocent and Pathologic Pediatric Heart Murmurs: A Case Report

Pediatric heart murmurs are common findings during physical examination, but only a small number of cases require intervention. This case report highlights a routine physical examination for a 10-year-old male patient that revealed a grade III/VI harsh systolic murmur heard in all areas of auscultation and a fixed split S2. A subsequent transthoracic echocardiogram showed an atrial septal defect that required catheter-based closure. This case proved to be one of the few cases in which urgent treatment of the heart murmur is required, and it helps highlight the features of pathologic murmurs that should prompt further evaluation.