الفهرس 
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Abstract
Cardiac murmurs are a common finding during a pediatric cardiac examination .Heart murmurs may be innocent (normal) or pathologic .The vast majority of murmurs are innocent in nature .Finding murmurs are a source anxiety and the most common reason for referral to a pediatric cardiologist and performance of echocardiogram. Aim of the work: To assess whether cardiac auscultation performed by pediatric trainees, pediatricians and pediatric cardiologists can reliably distinguish innocent from pathological heart murmurs in asymptomatic newborns, infants and children. Subjects and methods: Our subjects were all asymptomatic neonates, infants and children referred for transthoracic echocardiography in Pediatric Cardiology Unit at Mansoura University Children’s Hospital from February 2014 to January 2015 .All subjects enrolled in the study were 100 subjects and were classified into 3 groups to assess the relative incidence of innocent and pathologic murmur among different age group as follow:neonates ,infants and children. Methodes were taking history ,cardiac examination and Echocardiogram. Results showed that clinical skills of pediatric trainees in cardiac auscultation still need improvement and training to avoid over diagnosis of innocent murmurs. Echocardiography, including Doppler and color-Doppler techniques, even though it may be diagnostic in children with suspected heart disease, is unnecessary if the murmur is clinically deemed to be innocent.