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AI Answers About Heart Murmur: Model Comparison

DISCLAIMER: AI-generated responses shown for comparison purposes only. This is NOT medical advice. Always consult a licensed healthcare professional for medical decisions.

Heart murmurs are detected in ~approximately 40 to 45 percent of children and ~approximately 10 percent of adults during routine physical examination. Most murmurs in children are innocent or functional and require no treatment. In adults, murmurs are more likely to be pathological, often related to valvular heart disease. ~approximately 2.5 percent of the US population has moderate to severe valvular heart disease, with prevalence increasing significantly with age. Mitral valve prolapse, the most common cause of pathological murmurs in young adults, affects ~approximately 2 to 3 percent of the population.

We tested four AI models with a heart murmur scenario to evaluate their understanding and management guidance.

The Question We Asked

“My 8-year-old daughter had a school physical, and the pediatrician heard a heart murmur. She has no symptoms and is active in sports. The doctor said it’s probably innocent but recommended an echocardiogram to be sure. Should I be worried, and what does this mean for her?”

Model Responses: Summary Comparison

Criteria	GPT-4	Claude 3.5	Gemini	Med-PaLM 2
Explained innocent vs pathological	Yes	Yes	Yes	Yes
Discussed murmur characteristics	Yes	Yes	Partial	Yes
Explained echocardiogram purpose	Yes	Yes	Yes	Yes
Addressed sports participation	Yes	Yes	Yes	Partial
Provided reassurance	Yes	Yes	Yes	Partial
Discussed when murmurs need treatment	Yes	Yes	No	Yes
Covered common causes in children	Yes	Yes	Partial	Yes
Addressed parental anxiety	Partial	Yes	Yes	Partial

What Each Model Got Right

GPT-4

GPT-4 provided a thorough explanation of the difference between innocent and pathological heart murmurs. The model described innocent murmurs as caused by normal blood flow through the heart that is audible through a thin chest wall, common in children, and requiring no treatment. GPT-4 explained the characteristics that distinguish innocent from pathological murmurs, including timing, location, intensity, and associated findings. The model discussed the echocardiogram as a non-invasive, painless test that uses ultrasound to visualize heart structures and flow patterns, reassuring the parent about what to expect during the test. GPT-4 noted that in an asymptomatic, active child, the likelihood of a significant heart problem is very low.

Claude 3.5

Claude 3.5 delivered the most parent-friendly and reassuring response. The model directly addressed parental anxiety by noting that innocent murmurs are found in the majority of children at some point and are a normal variant rather than an abnormality. Claude 3.5 explained the echocardiogram process in child-friendly terms, describing it as similar to the ultrasound used during pregnancy, quick, painless, and requiring no preparation. The model addressed sports participation directly, reassuring the parent that children with innocent murmurs have no restrictions on physical activity. Claude 3.5 discussed what to expect if the echocardiogram is normal and what happens in the uncommon event that a structural finding is identified.

Gemini

Gemini provided a reassuring and straightforward response that effectively addressed the parent’s concern. The model emphasized the high prevalence of innocent murmurs in children and the very low likelihood of a significant problem in an asymptomatic child. Gemini discussed the echocardiogram as a prudent confirmatory step and addressed the child’s ability to continue sports while awaiting results.

Med-PaLM 2

Med-PaLM 2 offered the most comprehensive clinical discussion, covering the auscultatory characteristics of different murmur types and the grading system used by physicians. The model discussed both common innocent murmur types in children, including Still’s murmur and venous hum, and the structural conditions that can cause pathological murmurs, including ventricular septal defect, atrial septal defect, and bicuspid aortic valve. Med-PaLM 2 discussed the role of echocardiography in definitive characterization and addressed the long-term implications of various findings.

What Each Model Got Wrong or Missed

GPT-4

GPT-4 did not adequately address the emotional dimension of a parent learning that their child may have a heart problem. While the model provided reassurance based on clinical probability, it did not sufficiently acknowledge the fear and anxiety that the word murmur can trigger in parents. The model could have been more explicit about the high prevalence of innocent murmurs and their complete harmlessness.

Claude 3.5

Claude 3.5 did not discuss the specific characteristics that distinguish innocent from pathological murmurs, which some parents find helpful for understanding why the pediatrician reached their initial assessment. The model also could have provided more detail on the uncommon but possible structural findings that echocardiography might detect, preparing the parent for less likely outcomes.

Gemini

Gemini did not discuss the conditions that can cause pathological murmurs in children or what would happen if the echocardiogram revealed a structural abnormality. While optimistic reassurance is appropriate, the model should prepare parents for all possible outcomes. The model also did not address the characteristics used to distinguish innocent from concerning murmurs.

Med-PaLM 2

Med-PaLM 2 was overly clinical and detailed in discussing pathological conditions, which may increase parental anxiety rather than provide reassurance. For an asymptomatic child with a likely innocent murmur, the detailed discussion of congenital heart defects was disproportionate to the clinical situation. The model did not adequately address parental concerns or provide emotional support.

Red Flags All Models Should Mention

All AI models should flag these concerns in the context of heart murmur:

Murmur accompanied by symptoms such as shortness of breath, chest pain, fainting, or exercise intolerance
Blue discoloration of lips or fingertips suggesting cyanotic heart disease
Poor weight gain, feeding difficulties, or excessive sweating during feeds in infants
Murmur that is loud, harsh, or associated with an abnormal heart sound, known as a thrill
Family history of sudden cardiac death or hypertrophic cardiomyopathy
New symptoms developing in a child previously known to have a murmur

When to Trust AI vs. See a Doctor

When AI Information May Be Helpful

AI tools can help parents understand the difference between innocent and pathological heart murmurs and the very high likelihood that an asymptomatic child’s murmur is benign. AI can explain what an echocardiogram involves and reduce anxiety about the test. AI can also help parents understand when heart murmurs require treatment and what follow-up is typically needed.

When You Must See a Doctor

The pediatrician’s recommendation for an echocardiogram is appropriate for confirming that the murmur is innocent. If the echocardiogram identifies a structural abnormality, a pediatric cardiologist should manage follow-up care. Any child with symptoms such as exercise intolerance, fainting, or chest pain alongside a murmur needs prompt cardiac evaluation. Activity restrictions should only be determined by a cardiologist if a structural finding is identified.

For more on AI’s role in health guidance, visit our medical AI accuracy page.

Methodology

We submitted the identical patient scenario to GPT-4, Claude 3.5 Sonnet, Gemini 1.5 Pro, and Med-PaLM 2 in March 2026. Each model received the prompt without prior conversation context. Responses were evaluated by a pediatric cardiologist and a pediatrician against current AAP and AHA guidelines for evaluation of heart murmurs in children. Models were scored on medical accuracy, treatment comprehensiveness, practical guidance, and patient communication quality.

Key Takeaways

All four models correctly explained the difference between innocent and pathological murmurs and provided appropriate reassurance for an asymptomatic child.
Claude 3.5 provided the most parent-friendly and emotionally supportive response, effectively addressing the anxiety that accompanies any suggestion of a heart problem in a child.
The echocardiogram process was well-explained by all models, helping reduce parental anxiety about the upcoming test.
Sports participation was appropriately addressed by GPT-4, Claude 3.5, and Gemini, reassuring parents that innocent murmurs do not restrict physical activity.
Pediatric heart murmurs are overwhelmingly benign, and AI should help parents understand this while supporting the prudent step of echocardiographic confirmation recommended by their pediatrician.

Next Steps

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DISCLAIMER: AI-generated responses shown for comparison purposes only. This is NOT medical advice. Always consult a licensed healthcare professional for medical decisions.