How is Still's Murmur Differentiated from Pathological Murmurs?
Differentiating Still's murmur from pathological murmurs is crucial. Pediatricians use several criteria to distinguish between innocent and potentially harmful murmurs:
1. Sound Quality: Still's murmur has a musical or vibratory quality, while pathological murmurs may sound harsh or blowing. 2. Location and Timing: Still's murmur is usually heard best at the lower left sternal border and occurs during systole. Pathological murmurs may be heard in different locations and may occur during diastole. 3. Intensity: Innocent murmurs are typically low in intensity and do not radiate widely. Pathological murmurs may be louder and radiate to other parts of the chest or back. 4. Response to Position Changes: Innocent murmurs may change or disappear with changes in body position, while pathological murmurs are usually unaffected by position.
