The development of fetal echocardiography provides a powerful tool for the early detection of precordial disease. If an abnormal four-chambered heart is found on delivery, the obstetrician should refer the pregnant woman to a pediatric cardiologist for a detailed fetal heart echocardiogram. If a fetal heart abnormality is found, a pediatric cardiologist can work with the obstetrician to develop an appropriate mode of delivery. Pregnant women who have given birth to a child with preterm heart disease and are pregnant again, or who have very clear risk factors for preterm heart disease, can visit a specialist pediatric cardiologist for a fetal echocardiogram after 18 weeks of pregnancy to facilitate early detection and management of preterm heart disease. Is a murmur a precordial disease? A heart murmur can be heard in a child without heart disease, and is called a “functional murmur” or “unrelated murmur”. It is thought that the murmur occurs because the normal vibration is enhanced by the blood flow in the pediatric pulmonary artery. The murmur is variable, sometimes light, sometimes more pronounced, sometimes even absent, and is generally soft. It is usually more pronounced after a child has a fever, cries, exercises vigorously or lies flat, and diminishes after the fever subsides, when quiet or after sitting up. Therefore, a murmur in a child’s heart does not necessarily mean that he or she has preexisting heart disease. When a murmur is found in a child’s heart, the first thing to do is to go to a specialist for an examination, mainly an echocardiogram, which will clarify whether the child has a precordial disease. There are also some precordial diseases that do not have murmurs, so this alone should not negate the diagnosis of precordial disease. As for the loudness and pitch of the murmur is also different, some precordial disease abnormal channel is very small, blood flow through it will appear high pitch louder murmur; while other abnormal channel caliber is larger, blood flow through the murmur produced by the tone is lower and lighter. Obviously, the larger the abnormal channel opening, the more serious the lesion. Therefore, the severity of the disease should not be judged only by the loudness and pitch of the murmur.