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Four term infants with transient murmurs resembling that of pulmonary artery stenosis were examined. A grade 3/6 systolic ejection murmur was transmitted clearly to the entire precordium and the back. This murmur was first detected 7 days after birth in 1 infant and at a 1-month medical check in the other 3. The murmur continued for 7 to 22 weeks, with an average of 12 weeks. It gradually localized in the region of the left sternal border, and eventually disappeared. At the first medical examination, peak velocities of over 2.0 m/s, in the left or right pulmonary artery, were detected by a pulsed Doppler. The diameter of the right pulmonary artery was small (mean, 58 +/- 8%; range, 46 to 64% of predicted normal). When the heart murmur disappeared, the diameter of the right pulmonary artery (mean, 97 +/- 28%; range, 70 to 126%) had increased significantly (p &lt; 0.05). Peak velocities in the right pulmonary arteries had decreased significantly (2.22 +/- 0.37 m/s vs 1.13 +/- 0.10 m/s, p &lt; 0.01). We suggest that hypoplasia of pulmonary artery branches, in relation to the main trunk, is the main cause of the murmur resembling pulmonary artery stenosis.

Evaluation of transient heart murmur resembling pulmonary artery stenosis in term infants by Doppler and M-mode echocardiography.