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Fifteen-minute consultation: Cardiac murmurs in the Newborn Infant Physical Examination (NIPE)
  1. Abhishek Oswal,
  2. Jennifer Holman
  1. Department of Paediatrics and Neonatology, Gloucestershire Royal Hospital, Gloucester, UK
  1. Correspondence to Dr Abhishek Oswal, Department of Paediatrics and Neonatology, Gloucestershire Royal Hospital, Gloucester GL1 3NN, UK; abhishekoswal{at}


The finding of a cardiac murmur on the initial newborn examination is common but may be a source of anxiety for practitioners due to worries about missing critical congenital heart defects (CHDs). This article aims to provide an approach to this common finding, in particular, reviewing the evidence base behind features of the history, examination and subsequent non-specialist investigations which may increase the likelihood of CHDs. The aim of this structured approach is to give clinicians confidence in dealing with this common clinical finding, to be able to pick out those infants most at risk of having critical CHDs.

  • cardiology
  • neonatology

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  • Contributors AO drafted the manuscript. JH edited the manuscript and provided supervision for the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.