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Abstract The presence of a systolic murmur does not necessarily mean the presence f an organic heart disease. A large proportion of children, mounting up to 0%, demonstrate a systolic murmur with their hearts completely free from hysiological or anatomical abnormalities. These murmurs are called innocent nunnurs. In the present study conducted on 1523 primary school children in Shebin L-Kom, city the prevalence of innocent systolic murmurs was 22.98%, with lighest prevalence at the age group 6 years and 7 years, with predominance in nales than females. Heart rate and body surface area were not related to the resence of the murmurs. Also, in the present study 60 children with innocent murmurs and 20 hildren without murmurs were examined by E.C.G, M-mode, 2 D echo and Soppier to prove or disprove the innocence of the murmurs to evaluate the •ehability of clinical examination alone and the need for further costly nvestigations in this benign common condition, and it was also a trial for •ecognition of the genesis of the murmurs. 53 children were found to be completely normal (88.33%), 5 had bicuspid sortie valve (8.33%) and 2 had mitral valve prolapse (3.33%). Both conditions hvere unrelated to the murmurs since there was no stenosis or regurge. |