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Norman J. Sissman, MD
Professor of Pediatrics Division of Pediatric Cardiology University of Medicine and Dentistry of New Jersey One Robert Wood Johnson Place—Cn 19 New Brunswick, NJ 08903-0019

Arch Pediatr Adolesc Med. 1996;150(7):771.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The article by McCrindle et al¹ in the February 1996 issue of the ARCHIVES is a valuable contribution to efforts to make the referrals of infants and children to pediatric cardiologists for evaluation of murmurs more rational and efficient. I was disappointed that the authors made only passing reference to the key issue of how to improve our education of non-cardiologists in auscultation of the heart, so they may become more confident in recognizing innocent murmurs.

I was interested, also, to observe that the authors did not discuss 1 clinical feature from the history that had a P value of less than. 001, namely, the "age at encounter." Clearly, if a murmur is heard for the first time after the age of 1 year, the statistical chances of that murmur's arising from a cardiac lesion are low. Experienced clinicians have recognized this since the early days of pediatric cardiology; emphasizing . . . [Full Text PDF of this Article]

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