222 children with newly dx'd heart murmur evaluated with EKG and echo (Arch. Pediatr. Adolesc. Med 150:169, 1996-JW)
- 33% had true cardiac disease
- Clinical exam would have led to error in 7% of kids (4% false-pos; 3% false neg)
- Independent predictors of sig, disease:
- Pansystolic murmur
- III/VI or louder murmur
- Murmur at left upper sternal border
- Early or midsystolic click
- Abnormal S2