II. History

  1. First described by Dr. George Still (1909)

III. Epidemiology

  1. Common in children ages 2 to 8 years old

IV. Signs

  1. Low to medium frequency, mid-Systolic Murmur
  2. Intensity: Grade II-III of VI (variable)
  3. Location: near apex to lower left sternal border
  4. Character
    1. Low to medium pitch
    2. Vibratory, harmonic, musical, twanging, groaning
  5. Provocative conditions and positions (increased murmur)
    1. Supine position (decreased with standing)
    2. Fever
    3. Anemia

V. Differential Diagnosis

  1. Ventricular Septal Defect
  2. Left ventricular outflow obstruction
  3. Hypertrophic Cardiomyopathy

VI. Course

  1. Innocent murmur

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