All of the following are features of a benign heart murmur except
(C) Radiating to the lower chest # FUNCTIONAL MURMUR (innocent murmur, physiologic murmur) is a heart murmur that is primarily due to physiologic conditions outside the heart, as opposed to structural defects in the heart itself.> Serious conditions can arise even in the absence of a primary heart defect, and it is possible for peripheral conditions to generate abnormalities in the heart. Therefore, caution should be applied to use of the terms "innocent" or "benign" in this context.> Characteristics: - Soft, less than 3/6 in intensity (although note that even when structural heart disease is present, intensity does not predict severity.)> Often position-dependent (Murmurs heard while supine and may disappear when upright or sitting.)> Otherwise healthy individual, no concerns about growth, no symptoms of heart failure such as dyspnea on exertion. (In infants, ask if the baby tires during feeding, becomes diaphoretic, or develops a rapid respiratory rate. In older children, this can be elucidated by asking whether or not the child can keep up with peers during play.)> Occurs during systole or continuously during both systole and diastole. (Murmurs occurring only during diastole are always pathologic.)> Physiologic splitting of S2 (A2 and P2 components should only be resolvable during inspiration and should merge during expiration.)> No palpable thrill (A thrill is a vibration caused by turbulent blood flow.)
Mid systolic
Heard at the left sternal area
Radiating to the lower chest
Soft
Miscellaneous