Some children are referred for a systolic murmur (heart murmur that occurs during systole, the contraction phase of the heart). Virtually all children and adults with a normal heart have an innocent (normal) murmur sometime during their lifetime. Since the distinction between a normal and a pathologic heart noise can be difficult, some children a referred to pediatric cardiology to safely exclude an underlying heart defect.

A patent foramen ovale is a hole in the wall of tissue (septum) between the left and right upper chambers of the heart (atria). Every human fetus has this hole. When a newborn takes his first breath, the foramen ovale closes in about 75%. When it remains open, it is called a patent foramen ovale, patent meaning open. If the foramen ovale does not close immediately after birth, it often closes during the first weeks or months of life. But even if not, this is not a problem for the vast majority of people. Problems can arise when the blood that is leaking from the right to the left atrium contains a blood clot, e.g. in elder people or in persons at risk for thromboembolic events. It can also be problematic when considering scuba diving (higher risk of arterial gas embolism).

Patent ductus arterious is a persistent opening between the two major blood vessels leading from the heart. The opening, called the ductus arteriosus, is a normal part of a baby`s circulatory system before birth that usually closes shortly after birth. If it remains open, however, it is called a patent ductus arteriosus.

A small PDA can make the lungs and heart work harder, weakening the heart and causing heart failure and other complications. Treatment options for a PDA include monitoring, medication and closure by cardiac catheterization or surgery.

An atrial septal defect (ASD) is a hole in the wall (septum) between the two upper chambers of the heart (atria). The condition is present at birth.

Small defects might be found by chance and never cause a problem. Some small atrial septal defects close during infancy and early childhood. A large, long-standing ASD can damage heart and lungs. Surgery or device closure might be necessary to repair atrial septal defects to prevent complications.