What makes a heart murmur innocent?

The physician determines that a murmur is innocent by evaluating it on its own merits. The information should be assessed in a logical and orderly fashion, and the possibilities are considered based on the information that is obtained. All of this information is processed through the physician's knowledge and experience base, and then a decision is made. One cannot increase one's skill as a cardiac auscultator by reading articles such as this-one can only learn what is abnormal by being completely comfortable with what is normal. There is no substitution for listening to many hearts, but the physician must listen to normal hearts thoughtfully and analytically. What makes a heart murmur innocent? The answer to this question includes the characteristics of the murmur in the context of the patient's total cardiovascular examination. How are these characteristics determined? They are determined the same way as any other technical skill is accomplished-with practice.