Primary care physicians (PCPs) often lack the skills to distinguish the common innocent Still’s murmur from far less frequent but potentially serious pathological heart murmurs. This leads to approximately 800,000 children being referred to pediatric cardiologists each year for evaluation of heart murmurs in the United States [1–2]. The murmur is ultimately diagnosed as an innocent Still’s murmur in approximately 78% of these children (Children’s National Health System data). These unnecessary referrals and associated tests cost the healthcare system over half a billion annually, and are a source of avoidable anxiety for children and families while waiting to see a pediatric cardiologist.

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