Objective: Despite the fact that the vast majority of murmurs heard in children are innocent, the most common cause of pediatric cardiology consultation is cardiac murmur all around the world. The aim of this study was to compare the auscultation results with the findings of echocardiography.

Material and Methods: We have assessed the auscultation and echocardiography results of 667 patients referred to the pediatric cardiology clinic with a diagnosis of cardiac murmur between December 2011 and June 2012.

Results: The mean age of patients was 5.1 years and 54.6% of patients were male. There was no complaint accompanying cardiac murmur in 67.3% of the patients. The murmurs were considered pathological in 7.9% of patients. Echocardiographic examination was normal in 58.3% of patients, whereas various echocardiographic findings were detected in 41.7% of the patients. The most common findings were patent foramen ovale (PFO) (24.9%), atrial septal defect (ASD) (8.4%) and pulmonary stenosis (5.7%). There were various echocardiographic findings such as small ASD or trace valvular regurgitations in 38.4% of patients, while their murmurs were considered innocent. Accordingly, the results of physical examination and echocardiography showed statistically significant differences (p <0.001). After elimination of physiological mitral regurgitation and PFO, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate of physical examination to discriminate between normal and abnormal echocardiographic findings was 31%, 99.2%, 92.5%, 82.2% and 83% respectively. conclusion: This study showed that some minor cardiac defects can be missed by auscultation in patients referred to pediatric cardiology clinics because of cardiac murmurs. Therefore, these patients should be evaluated by echocardiography

Keywords: Children, Echocardiography, Physical examination, Cardiac murmur