{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:51:38Z","timestamp":1777524698466,"version":"3.51.4"},"reference-count":9,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2000,9,1]],"date-time":"2000-09-01T00:00:00Z","timestamp":967766400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Pediatr (Phila)"],"published-print":{"date-parts":[[2000,9]]},"abstract":"<jats:p>A cardiac murmur is a very common finding in the first few days of life. It is traditionally believed that lesions creating left-to-right shunts do not present so early. This study was aimed to define and to classify the causes of a murmur in a newborn with an otherwise normal examination. All echocardiograms performed on newborns aged 1-5 days who were referred for evaluation of a murmur in a 3-year period were reviewed. Newborns with additional clinical signs or antenatal diagnosis of a cardiac disease were excluded. Of 20,323 live births, there were 170 newborns referred for echocardiogram solely because of a murmur. Of these, 147 (86%) were found to have structural heart defects. The most common lesions found were those creating left-to-right shunts (66%). Ventricular septal defect was the most common single lesion (54\/147, 37%), followed by patent ductus arteriosus (34 newborns, 23%). The combination of both was found in 10 newborns (7%). Six newborns (4%) had pulmonary valve stenosis and three (2%) aortic valve stenosis. Seven newborns (5%) had unforeseen complex heart disease. For five of them, delayed diagnosis would have resulted in potentially life-threatening conditions. There was no correlation between the category of lesion and the age of presentation. The audible threshold of a murmur correlated with a maximum instantaneous gradient of 25 mm Hg (range 11-46 mm Hg). Thirteen percent of newborns with isolated heart murmur had no identifiable structural heart disease. These data suggest that most asymptomatic newborns presenting with a murmur in the first days of life have structural heart disease. Some of the more serious defects would not have been diagnosed without early echocardiography. A left-to-right shunt, particularly a ventricular septal defect, may cause a murmur even the first day of life and is probably more common that has been acknowledged.<\/jats:p>","DOI":"10.1177\/000992280003900902","type":"journal-article","created":{"date-parts":[[2007,6,21]],"date-time":"2007-06-21T21:21:41Z","timestamp":1182460901000},"page":"511-520","source":"Crossref","is-referenced-by-count":36,"title":["Significance of a Cardiac Murmur as the Sole Clinical Sign in the Newborn"],"prefix":"10.1177","volume":"39","author":[{"given":"Azaria J. J. T.","family":"Rein","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hadassah-Hebrew University Hospital, Kiryat Hadassah, POB 12000, Jerusalem, 91120, Israel; Pediatric Cardiology, Department of Cardiology, Hadassah University Hospital, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel l.","family":"Omokhodion","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amiram","family":"Nir","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Department of Cardiology, Hadassah University Hospital, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2000,9,1]]},"reference":[{"key":"atypb1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.63.10_Spec_No.1172"},{"key":"atypb2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(90)90538-C"},{"key":"atypb3","doi-asserted-by":"publisher","DOI":"10.1159\/000244317"},{"key":"atypb4","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a113979"},{"key":"atypb5","first-page":"1092","volume-title":"The Science and Practice of Pediatric Cardiology","author":"Rosenthal G","year":"1998"},{"key":"atypb6","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1542\/peds.27.4.551","volume":"27","author":"Rudolph AM","year":"1961","journal-title":"Pediatrics"},{"key":"atypb7","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(64)80395-4"},{"key":"atypb8","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.76.5.1029"},{"key":"atypb9","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)90392-1"}],"container-title":["Clinical Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/000992280003900902","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/000992280003900902","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:24:05Z","timestamp":1777393445000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/000992280003900902"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,9]]},"references-count":9,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2000,9]]}},"alternative-id":["10.1177\/000992280003900902"],"URL":"https:\/\/doi.org\/10.1177\/000992280003900902","relation":{},"ISSN":["0009-9228","1938-2707"],"issn-type":[{"value":"0009-9228","type":"print"},{"value":"1938-2707","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,9]]}}}