Why does a child's heart have a murmur during a physical examination?

Patient's question:

The child has had a cold for nearly half a month, with nasal congestion, runny nose, and coughing. Besides the persistent lethargy, there has been no significant improvement. During the recent thorough medical check-up at the hospital, the doctor diagnosed the child with bronchopneumonia and also recommended an echocardiogram.
Hello expert, what could cause heart murmurs in a child during a health check-up?

Doctor's answer:

During the child's health check, a heart murmur reappeared. This could be a physiological phenomenon, such as when the child has a fever or after intense exercise, which might cause the heart murmur to reappear. It could also be a pathological phenomenon. If the child's heart develops a disease again, especially if the heart valves are affected, it is likely to cause the heart murmur to reappear. Currently, the child must undergo an echocardiogram to confirm whether there is any heart disease.

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