{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:24:56Z","timestamp":1777526696490,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2016,7,19]],"date-time":"2016-07-19T00:00:00Z","timestamp":1468886400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Pediatr (Phila)"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:p>An asymptomatic child with a murmur can be challenging practice management conundrum. Some providers refer all patients with a \u201cnew\u201d murmur to a cardiologist, likely resulting in excessive resource utilization and parental anxiety. This study examines whether the prevalence of significant cardiac pathology differs in asymptomatic patients aged 2 to 18 years who were referred for a murmur that was \u201cnew\u201d versus those referred for a murmur that was known to exist and followed conservatively during the previous 2 years. Of 473 patients meeting inclusion criteria, 33\/473 (7.0%) were diagnosed with cardiac pathology, with 21\/357 (5.9%) occurring among \u201cnew\u201d murmur referrals and 12\/116 (10.3%) occurring among \u201cknown\u201d murmur referrals. Notably, 34\/357 (9.5%) patients referred for a \u201cnew\u201d murmur had no murmur present when assessed by the cardiologist. This study suggests that asymptomatic children with a \u201cnew\u201d murmur may be conservatively managed. This may lessen health care resource utilization rates and overall parental anxiety.<\/jats:p>","DOI":"10.1177\/0009922816656623","type":"journal-article","created":{"date-parts":[[2016,6,29]],"date-time":"2016-06-29T20:09:28Z","timestamp":1467230968000},"page":"357-362","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Managing a \u201cNew\u201d Murmur in Healthy Children and Teens"],"prefix":"10.1177","volume":"56","author":[{"given":"Lisa J.","family":"Gupta","sequence":"first","affiliation":[{"name":"Walter Reed National Military Medical Center, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph W.","family":"May","sequence":"additional","affiliation":[{"name":"Walter Reed National Military Medical Center, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,7,19]]},"reference":[{"key":"bibr1-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198301133080201"},{"key":"bibr2-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(60)90408-7"},{"key":"bibr3-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1996.02170270051007"},{"key":"bibr4-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4471-1814-5"},{"key":"bibr5-0009922816656623","first-page":"529","volume-title":"Moss and Adams\u2019 Heart Disease in Infants, Children, and Adolescents","author":"Boggo LD","year":"2008"},{"key":"bibr6-0009922816656623","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1542\/peds.86.4.497","volume":"86","author":"Smythe JF","year":"1990","journal-title":"Pediatrics"},{"key":"bibr7-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5273(88)90196-9"},{"key":"bibr8-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.305.6864.1264"},{"key":"bibr9-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1542\/peds.105.6.1184"},{"key":"bibr10-0009922816656623","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-119-1-199307010-00009"},{"key":"bibr11-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03550090041030"},{"key":"bibr12-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1136\/adc.81.5.409"},{"key":"bibr13-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1177\/000992289903800902"},{"key":"bibr14-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1177\/000992289903800903"},{"key":"bibr15-0009922816656623","first-page":"406","volume":"18","author":"Giuffre RM","year":"2002","journal-title":"Can J Cardiol"},{"key":"bibr16-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1995.tb13573.x"},{"key":"bibr17-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1007\/BF02072620"},{"key":"bibr18-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1542\/peds.99.1.1"},{"key":"bibr19-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2003.08.001"},{"key":"bibr20-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-0803.2012.00637.x"},{"key":"bibr21-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2002.127502"},{"key":"bibr22-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1016\/j.cupe.2005.08.002"},{"key":"bibr23-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8175.1995.tb00535.x"},{"key":"bibr24-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2008.06.017"},{"key":"bibr25-0009922816656623","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.08.001"},{"key":"bibr26-0009922816656623","unstructured":"Centers for Medicare & Medicaid Services. 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