11th May 2024

A 4-year-old boy is referred to a paediatric cardiologist for evaluation of a heart murmur.

A 4-year-old boy is referred to a paediatric cardiologist for evaluation of a heart murmur. The child is asymptomatic with normal growth and development. On examination, the cardiologist notes a prominent jugular venous pulse and a palpable liver edge. Auscultation reveals a holosystolic murmur heard best at the lower left sternal border. An echocardiogram confirms moderate tricuspid regurgitation (TR) without evidence of other structural heart defects. The child’s parents are anxious and request guidance on the best approach to their child’s condition.

Which is the most appropriate next step in management?