What causes a Still's murmur?

In fact, no one knows exactly what causes a Still’s murmur. People have looked very closely using ultrasound at the hearts of children with this murmur and compared them to the hearts of children who do not. No difference has ever been identified. It is very clear however, that the Still’s murmur is not caused by any type of heart defect. It is likely that young children have very healthy, elastic hearts that “ring” when the blood gets pumped at a particular speed, like blowing over the top of a soda bottle.

Who can have a Still's murmur?

The Still’s murmur may occur in as many as one third of all children between 2 and 5 years of age. It can, however, be heard in children ranging in age from newborns to young adults. Commonly, a Still’s murmur will come and go over time.

What does it mean if my child's has a Still's murmur?

It is very important to understand that the Still’s murmur is perfectly normal. It does not suggest any type of heart disorder. Children with a Still’s murmur can play sports just like any other normal child, and do not require special medical treatment when they go to the dentist or have other medical procedures. In fact, it is perfectly fine not to mention this murmur when one is filling out forms for insurance companies, school sports clearance, and dental visits. Finally, it is not generally necessary for a child with a Still’s murmur to have additional visits with a cardiologist unless they are under a year of age, in which case one additional visit is sometimes recommended just because a lot of changes take place in a child’s heart over the first year of life.

What do I tell loved ones about my child's condition?

An accurate description of a Still’s murmur is to say that your child has a “musical heart.”

Who can I contact if I have questions?

Please don’t hesitate to contact Pediatric Cardiology at MassGeneral Hospital for Children at 888-644-3248 if you have any additional questions about your child’s heart.

History of the Still’s murmur

The Still’s murmur was initially described by a pediatrician named George Frederic Still, MD, in his pediatric textbook Common Disorders and Diseases of Childhood published in 1909. In his book, Still notes:

“I should like to draw attention to a particular bruit which has somewhat of a musical character, but is neither of sinister omen nor does it indicate endocarditis of any sort. …its characteristic feature is a twangy sound, very like that made by twanging a piece of tense string... Whenever may be its origin, I think it is clearly functional, that is to say, not due to any organic disease of the heart either congenital or acquired.”

Rev. 9/2018. MassGeneral Hospital for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.