Prevalence and diagnostic accuracy of heart disease in children with asymptomatic murmurs

2015 ◽  
Vol 26 (3) ◽  
pp. 446-450 ◽  
Author(s):  
Adziri H. Sackey
Keyword(s):  
Heart Disease ◽  
Diagnostic Accuracy ◽  
Clinical Examination ◽  
Clinical Assessment ◽  
Congenital Heart ◽  
Heart Murmur ◽  
Paediatric Cardiologist ◽  
Heart Murmurs ◽  
Cardiology Clinic ◽  
Heart Lesions

AbstractThis study was performed to determine the prevalence of CHD among children referred with asymptomatic murmurs and to determine the diagnostic accuracy of the assessment of asymptomatic heart murmurs by general paediatricians. We reviewed the records of children who had been referred by general paediatricians to a cardiology clinic for further evaluation of a heart murmur. The referring paediatricians’ clinical assessment of the murmur was compared with the cardiologist’s echocardiographic diagnosis. A total of 150 children were referred by paediatricians to a paediatric cardiologist for further assessment of a heart murmur. Out of 150 children, 72 had a paediatrician’s diagnosis of innocent murmur; of these 72 patients, two (3%) had heart disease on echocardiography. In all, after echocardiography, a range of congenital heart lesions was found in 28 (19%) of the 150 children. CHD is not rare among children with asymptomatic heart murmurs. In this series of children with asymptomatic murmurs, 19% had heart lesions on echocardiography. Most, but not all, of the children with heart lesions were identified on clinical examination by general paediatricians.

Diagnostic accuracy of heart murmur in newborns with suspected congenital heart disease

2015 ◽  
Vol 16 (8) ◽  
pp. 556-561 ◽  
Author(s):  
Natale D. Brunetti ◽  
Simona Rosania ◽  
Carmine D’Antuono ◽  
Annamaria D’Antuono ◽  
Luisa De Gennaro ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Diagnostic Accuracy ◽  
Congenital Heart ◽  
Heart Murmur

scholarly journals Diagnosis of Neonatal Congenital Heart Disease: A Combination of Heart Murmur, SpO2 Abnormality, Tachypnea, and Extracardiac Malformations

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Kai Chen ◽  
Jiao Wang ◽  
Huihui Zhou ◽  
Xiang Huang
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Murmur ◽  
Heart Murmurs ◽  
Group A ◽  
Postnatal Outcome ◽  
Group B ◽  
Group D ◽  
Youden’S Index

Congenital heart disease (CHD) is one of the commonest congenital malformations that are mostly asymptomatic at birth, which challenges the diagnosis of neonatal CHD. An early accurate prenatal diagnosis will give parents a choice, as well as the opportunity to plan the delivery and improve the postnatal outcome. The purpose of the study is to evaluate the value of heart murmurs, SpO2 abnormalities, tachypnea, and extracardiac malformations in screening neonatal CHD. All 4500 newborns in the obstetrics department of our hospital from January 2019 to January 2020 are selected as study subjects. Newborns were grouped according with the presence of heart murmurs, tachypnea, transdermal SpO 2 < 95 % , and extracardiac malformations alone or in combination (≥3). Patients with murmur, tachypnea, and abnormal SpO2 were assigned into group A, those with murmur, tachypnea, and extracardiac malformations into group B, those with murmurs, SpO2, and extracardiac malformations into group C, those with SpO2, tachypnea, and extracardiac malformations into group D, and those with all four into group E. The color echocardiography identified 65 children with CHD (1.4%) among the included 4,500 newborns. When murmur, tachypnea, abnormal SpO2, and extracardiac malformation were independently used to diagnose CHD, the sensitivity ranged from 30.68% to 51.26%, with specificity ranging from 47.36% to 82.65% and Youden’s index (YI) ranging from 0.13 to 0.36. When murmur, tachypnea, abnormal SpO2, extracardiac malformation were together used to diagnose CHD, 91.23% sensitivity, 95.26 specificity, and 0.91 YI were observed. In conclusion, a combination of four indicators, murmur, tachypnea, abnormal SpO2, and extracardiac malformation yielded good performance in diagnosing neonatal CHD.

Heart Murmurs. If You Allow for Mistakes Costs Are Even Higher!

PEDIATRICS ◽  
1993 ◽  
Vol 92 (2) ◽  
pp. 304-304
Author(s):  
WARREN H. TOEWS
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Recent Article ◽  
Congenital Heart ◽  
Cost Assessment ◽  
Heart Murmur ◽  
Pediatric Cardiologist ◽  
Heart Murmurs ◽  
Echocardiographic Evaluation

To the Editor.— I read with the recent article by Danford et al regarding "cost assessment of heart murmur evaluation." I agree completely with the authors that echocardiographic evaluation of heart murmurs is more costly than referral to a pediatric cardiologist. In this study, the authors utilized echocardiograms ordered at their own institution, presumably performed by technicians trained and experienced in the evaluation of children for congenital heart disease, and interpreted by pediatric cardiologists trained and experienced in interpretation of pediatric echocardiograms.

scholarly journals Role of TEE in Improving Diagnostic Accuracy of Congenital Heart Disease

2014 ◽  
Vol 2 (2) ◽  
pp. 68-70
Author(s):  
Sandeep Singh Rana ◽  
Balbir Kumar ◽  
Sethu Madhavan J
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Diagnostic Accuracy ◽  
Multimodal Imaging ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Associated Lesions ◽  
Cardiac Lesions ◽  
Intraoperative Period

ABSTRACT Complex congenital heart diseases (CHD) often present as multiple cardiac lesions. The presence of one anomaly should stimulate the physician to perform a comprehensive assessment and look for other associated anomalies.1 Multimodal imaging may be necessary to diagnose such associated lesions as single imaging may occasionally miss them. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) are complimentary to each other. Routine use of TEE during intraoperative period may help us to refine diagnosis, detect the missing components and guide effective surgical repair. We present one such case where diagnosis and management were optimized by multimodal imaging. How to cite this article Kumar B, Madhavan JS, Puri GD, Rana SS. Role of TEE in Improving Diagnostic Accuracy of Congenital Heart Disease. J Perioper Echocardiogr 2014;2(2):68-70.

scholarly journals Multi‐Institutional Practice‐Patterns in Fetal Congenital Heart Disease Following Implementation of a Standardized Clinical Assessment and Management Plan

2021 ◽  
Author(s):  
Yalda Afshar ◽  
Whitnee J. Hogan ◽  
Charlotte Conturie ◽  
Sherzana Sunderji ◽  
Jennifer Y. Duffy ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Clinical Assessment ◽  
Congenital Heart ◽  
Intervention Group ◽  
Management Plan ◽  
University Of California ◽  
Maternal Risk ◽  
Early Term ◽  
Term Delivery

Background Prenatal diagnosis of congenital heart disease has been associated with early‐term delivery and cesarean delivery (CD). We implemented a multi‐institutional standardized clinical assessment and management plan (SCAMP) through the University of California Fetal‐Maternal Consortium. Our objective was to decrease early‐term (37–39 weeks) delivery and CD in pregnancies complicated by fetal congenital heart disease using a SCAMP methodology to improve practice in a high‐risk and clinically complex setting. Methods and Results University of California Fetal‐Maternal Consortium site‐specific management decisions were queried following SCAMP implementation. This contemporary intervention group was compared with a University of California Fetal‐Maternal Consortium historical cohort. Primary outcomes were early‐term delivery and CD. A total of 496 maternal–fetal dyads with prenatally diagnosed congenital heart disease were identified, 185 and 311 in the historical and intervention cohorts, respectively. Recommendation for later delivery resulted in a later gestational age at delivery (38.9 versus 38.1 weeks, P =0.01). After adjusting for maternal age and site, historical controls were more likely to have a CD (odds ratio [OR],1.8; 95% CI, 2.1–2.8; P =0.004) and more likely (OR, 2.1; 95% CI, 1.4–3.3) to have an early‐term delivery than the intervention group. Vaginal delivery was recommended in 77% of the cohort, resulting in 61% vaginal deliveries versus 50% in the control cohort ( P =0.03). Among pregnancies with major cardiac lesions (n=373), vaginal birth increased from 51% to 64% ( P =0.008) and deliveries ≥39 weeks increased from 33% to 48% ( P =0.004). Conclusions Implementation of a SCAMP decreased the rate of early‐term deliveries and CD for prenatal congenital heart disease. Development of clinical pathways may help standardize care, decrease maternal risk secondary to CD, improve neonatal outcomes, and reduce healthcare costs.

scholarly journals Risk Factors Associated with Congenital Heart Disease in Patients Presenting to Aljalila Cardiology Clinic between January 2020- May 2020: A Case Control Study

2021 ◽  
pp. 1-6
Author(s):  
Samah Alasrawi ◽  
◽  
Hessa Almansoori ◽  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Maternal Smoking ◽  
Congenital Heart ◽  
Case Control Study ◽  
Maternal Diabetes ◽  
Case Control ◽  
Cardiology Clinic ◽  
Control Study

Objective: To investigate the association of maternal diabetes, maternal smoking and syndromes with congenital heart disease (CHD) in patients attending Aljalila cardiology clinic between January 2020 and May of 2020. Methods: A case control study to assess the association of maternal diabetes, maternal smoking and syndromes with CHD. All patients that presented to the clinic between January 2020 and May of 2020 were included. An interviewer administered questionnaire was used to record the presence of maternal diabetes, maternal smoking, and the type of syndrome and type of CHD. Patients with CHD were included in the case group and patients who did not have CHD were in the control group. Age, gender, and nationality were also collected from the hospital records. Fisher exact test and logistic regression was used to analyze the results. Results: A total of 177 cases and 211 controls were recruited. All the risk factors increase the risk of CHD, with maternal diabetes (OR 6.3, 95% CI 2.7-14.6) having the strongest association, then syndromes (OR 5.1, 95% CI 2.3-11.3) and lastly maternal smoking (OR 4.0, 95% CI 1.0-16.3). The most common type of CHD is ventricular septal defect. Conclusion: Maternal diabetes, maternal smoking and syndromes are significant risk factors of CHD in children visiting Aljalila cardiology clinic. Action needs to be taken in order to decrease these risk factors and so, decrease the incidence of CHD in the future. Clearly, more research is needed in order to identify other risk factors for patients in the United Arab Emirates (UAE)

scholarly journals Importance of Cardiac Murmur in Diagnosing Congenital Heart Disease in Neonatal Period

1970 ◽  
Vol 32 (1) ◽  
pp. 17-20
Author(s):  
Md Mahbubul Hoque ◽  
Jotsna Ara Begum ◽  
Rawshan Jahan ◽  
MAK Azad Chowdhury ◽  
Manzoor Hussain
Keyword(s):  
Heart Disease ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Diseases ◽  
Gas Analysis ◽  
Heart Murmur ◽  
Cardiac Murmur ◽  
Transposition Of Great Arteries ◽  
Arterial Blood ◽  
Careful Clinical Examination

Introduction: Congenital heart diseases (CHD) are serious problem of perinatology, occur in 8/1000 live birth. Approximately one third of these neonates require intervention in the first month of life. Clinical features of CHD vary according to type of lesion. Presence or absence of a murmur does not assure either the presence or absence of significant CHD. This study was conducted to determine the clinical and echocardiographic evaluation of neonate with heart murmur and contribution of neonatal examination especially presence or absence of cardiac murmur in the detection of CHD. Method: The study was carried out in Special Care Baby Unit of Dhaka Shishu Hospital during the period from January 2004 to December 2004. Neonates having heart murmur or when there were some clues to doubt CHD like cyanosis, respiratory distress, heart failure, persistent low partial pressure of oxygen(PaO2) in arterial blood gas analysis were underwent echocardiography. CHD were classified according to the structural defect with the echocardiographic findings. Results: Total 812 neonates were admitted during one year period. Heart murmurs were found in 33 cases. Out of 33 cases 15 (45.45%) had CHD confirmed by echocardiography. Another 7 neonates were found to have CHD without murmur after echocardiography. In total 22 (2.7%) neonates had CHD. Pattern of CHD were Ventricular Septal Defect (VSD), Atrial Septal Defect (ASD), Transposition of Great Arteries (TGA), Tetralogy of Fallot (TOF) and Complex cyanotic heart disease. Conclusion: Infant with CHD may present with or without murmur. Careful clinical examination is mandatory in the initial evaluation of neonates to identify CHD. The infant having suggestive features for CHD with or without murmur should undergone echocardiography, so that appropriate intervention and counseling can be done. Key words: neonates; murmur; CHD. DOI: 10.3329/bjch.v32i1.6008 Bangladesh Journal of Child Health 2008; Vol.32(1): 17-20

scholarly journals Incidence of Congenital Heart Disease among Hospital Live Birth in a Tertiary Hospital of Bangladesh

1970 ◽  
Vol 1 (1) ◽  
pp. 14-20 ◽  
Author(s):  
NN Fatema ◽  
RB Chowdhury ◽  
L Chowdhury
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Early Detection ◽  
Live Birth ◽  
Congenital Heart ◽  
Septal Defect ◽  
Ductus Arteriosus ◽  
Military Hospital ◽  
Live Births ◽  
Paediatric Cardiologist

Background: Incidence of congenital heart disease is 8-10/1000 live birth which is established by many studies carried out in many centers worldwide. In Bangladesh no incidence study was carried out so far. Newborn children presenting with various forms of congenital heart disease is a common problem now a days. Neonatologists and paediatricians are now more conscious about early detection and treatment of newborn with congenital heart diseases. Diagnostic facilities are also available in many places. So an individual incidence record from an ideal center of our country is a demand of the time which led carrying out this study. Methods: This prospective study was carried out in Combined Military Hospital (CMH) Dhaka over a period of three years (2004 – 2006). All five thousand six hundred and sixty eight live births weighing more than 500 gm and more than 28 weeks gestational period were subjected to a thorough clinical examination within 72 hours of birth. Those suspected to have any form of congenital heart disease (CHD) were followed up every 4-6 wks for a period of 12 months. Echocardiography with color Doppler was performed in all these newborn including those who reported late but were delivered in obstetrics department of Combined Military Hospital Dhaka. Result: One hundred forty two babies out of 5668 live birth had CHD, ie, 25/1000 live births. Incidence of CHD was higher in pre terms as compared to full term live birth. Some of the patients (18.30%) has other associated somatic anomalies among which Down’s syndrome was commonest (9.15%). Most common congenital heart lesions were Atrial Septal Defect (ASD-26%), Ventricular Septal Defect (VSD-16.9%), Patent Ductus Arteriosus (PDA-18%), Tetralogy of Fallot (TOF-14%), Pulmonary Stenosis (PS-7.75%) etc. Those who were found to have congenital heart disease were managed accordingly. Some patients had spontaneous closure of defects in first year follow up period. Conclusion: The incidence of Congenital Heart Disease (CHD) depends upon various factors like nature of the samples (all live birth or all birth) or on the spot examination by a Paediatric cardiologist. A hospital which has Obstetric, Neonatal and Paediatric cardiology unit can carried out this kind of study successfully. In this study screening of asymptomatic high risk neonates also contributes in early detection of many trivial lesions. Severe lesions were also detected by the paediatric cardiologist who usually expire before being referred from other hospitals and before being diagnosis is established. So a higher incidence rate is recorded in this study. Key words: Congenital heart disease; Echocardiography DOI: http://dx.doi.org/10.3329/cardio.v1i1.8199 Cardiovasc. j. 2008; 1(1) : 14-20  

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