Murmur (Paediatric)

This condition is treated in the Cardiology clinic.

Emergency Referral Criteria

Criteria for Emergency include: 

• New murmur with any of the following concerning features: 
  • haemodynamic instability 
  • persistent or progressive shortness of breath with marked limitation of physical activity or worse.   
  • chest pain 
  • syncope/pre-syncope/dizziness 
  • neurological deficit indicative of TIA/stroke 
  • abnormal ECG (e.g. LV hypertrophy, AF, LBBB, RBBB) 
  • fever or constitutional symptoms suggestive of infection (e.g. endocarditis, acute rheumatic fever) 
  • signs of heart failure 

Murmur (infant) 

• Infant less than 3 months with newly noted murmur and any of the following concerning features: 
  • poor feeding 
  • slow weight gain 
  • weak or absent femoral pulses 
  • post ductal (foot) oxygen saturation less than 95% 
  • respiratory signs (wheeze, recession, or tachypnoea) 
• Murmur with cyanosis or heart failure 
• Syncope or seizures 

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Statewide Referral Criteria (SRC)

Criteria for referral to public hospital specialist clinic services

? Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Please note that all Paediatric Cardiology referrals will be assessed based on patient’s presenting symptoms.  Referrals will be on-referred to Paediatric Medicine Service on your behalf where appropriate. 

Urgent (Category 1)

• Asymptomatic murmur in a baby from birth to 3 months 
• Asymptomatic murmur at any age in association with acute rheumatic fever 
• Children already diagnosed with a condition with known cyanosis or heart failure 
• A child currently in out of home care (OOHC) or at risk of entering or leaving OOHC, where they have previously been on a waiting list for this problem and were removed without receiving a service 

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review.

Semi-urgent (Category 2)

• Asymptomatic murmur in a child aged 4 months to 2 years 
• Murmur at any age with a past history of rheumatic fever

Routine (Category 3)

• Asymptomatic murmur in a child over 2 years old

Information to be included in the referral

(Referral may be returned without this)

Essential supporting information

Pathology

• Nil essential

Imaging

• Nil essential

Investigations/other

• Nil essential

Additional information

• Physical findings including colour assessment or oxygen saturation 
• Report presence or absence of the following: 
  • History of exercise intolerance 
  • Cyanotic episodes or blue spells 
  • Weak or absent femoral pulses 
  • Clubbing 
• Confirmation of OOHC (where appropriate) 

Interim/GP management

To refer a patient with this condition, please see the Cardiology clinic page for the full referral process and templates.

View more information:

Cardiology - HealthPathways Tasmania

Heart Murmurs in Children and Adolescents - HealthPathways Tasmania

Additional resources

View more information on the Heart Foundation website

View all clinic availability