Functional murmur
systolic ejection murmur without any organic dysfunction
A functional murmur (innocent murmur, physiologic murmur) is a heart murmur that is primarily due to physiologic conditions outside the heart, as opposed to structural defects in the heart itself. Serious conditions can arise even in the absence of a primary heart defect, and it is possible for peripheral conditions to generate abnormalities in the heart. Therefore, caution should be applied to use of the terms "innocent" or "benign" in this context.Use of the term dates to the mid 19th century.
Benign pediatric heart murmur
Functional murmurs are an important consideration in the precordial examination of an infant or child.
Presentation
Soft, less than 3/6 in intensity (although note that even when structural heart disease is present, intensity does not predict severity.)
Often position-dependent. Murmurs heard while supine and may disappear when upright or sitting.
Otherwise healthy individual, no concerns about growth, no symptoms of heart failure such as dyspnea on exertion. (In infants, ask if the baby cries during feeding, becomes diaphoretic, or develops a rapid respiratory rate. In older children, this can be elucidated by asking whether or not the child can keep up with peers during play.)
Occurs during systole or continuously during both systole and diastole. (Murmurs occurring only during diastole are usually pathologic, but can also be heard during hyperdynamic states.)
Physiologic splitting of S2 (A2 and P2 components should only be resolvable during inspiration and should merge during expiration.)
No palpable thrill (A thrill is a vibration caused by turbulent blood flow.)
Diagnosis
Types, and DDx
In the adult, hyperdynamic circulation of the blood may also produce a functional murmur, such as in anemia or thyrotoxicosis.
This brief starts where responsible research should: with the source description of “Functional murmur” as systolic ejection murmur without any organic dysfunction. Everything that follows is an evidence route, not borrowed authority.
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Vocabulary and entity names are the principal evidence signals here, because they determine the precision of every later search. The source revision retrieved here is dated May 25, 2025. The linked authority identifier is Q3773761. None of the 0 selected statements returned an explicit reference.
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This entry incorporates text from “Functional murmur” on English Wikipedia. Contributors are listed in the page history. Text is available under the Creative Commons Attribution-ShareAlike 4.0 License. Selected authority identifiers and statements are retrieved from Wikidata under CC0; their references and qualifiers remain part of the verification path.