What is a heart murmur?

Heart murmur is a sound created by the blood circulation as it passes through the heart. When the anatomy of the heart is normal, the murmur is characterized as “functional or innocent”. However, when the heart’s anatomy is abnormal, the passage of blood through pathological valves or structures creates a much more intense or rough sound, which should be further checked by a Cardiologist with an ECG and echocardiogram.

Is a paediatric cardiac checkup obligatory?

A paediatric cardiac checkup is usually required to provide a sports certificate for children. Once the heart is found to be functionally and anatomically normal, a further echocardiogram is not necessary, except for the case that a child’s physical or health condition changes.

Should functional or innocent murmurs be followed-up?

No. When cardiac anatomy and function are found to be normal, regular visits to the doctor for re-testing are not necessary.

What is the Patent Ductus Arteriosus (PDA)?

The ductus arteriosus is a normal fetal artery connecting the main body artery (aorta) and the main lung artery (pulmonary artery). After birth, the communication is no longer needed, hence it usually narrows down and closes within the first few days from birth in the majority of cases. If the ductus arteriosus is still open above the age of 3 months, it is possible to remain open. In most cases, children can have their PDA closed by cardiac catheterization, when they are haemodynamically significant. The procedure is safe and entails a 1-day stay in the hospital. Once the duct is closed, no further interventions are required in the future.

What is the patent foramen ovale (PFO)? 

The foramen ovale is a normal communication, like a small hole, between the two upper chambers of the heart, which is found in all embryos. It is necessary for the fetal circulation and after birth it decreases in size and gradually closes. This process can be completed after a few months or years.

On a number of occasions, this communication persists and if it resumes bigger dimensions, it is called an atrial septal defect (ASD). If the ASD causes overload of the right side of the heart, it is recommended that it should be closed by either interventional catheterization or open-heart surgery, in the cases that the communication is not suitable for transcatheter closure.