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

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.

Download Full-text

Role of TEE in Improving Diagnostic Accuracy of Congenital Heart Disease

Journal of Perioperative Echocardiography ◽

10.5005/jp-journals-10034-1025 ◽

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.

Download Full-text

Diagnostic accuracy and clarity of steady-state free precession imaging of cardiac valve morphology in congenital heart disease

Archives of Cardiovascular Imaging ◽

10.4103/acvi.acvi_14_18 ◽

2018 ◽

Vol 6 (1) ◽

pp. 1

Author(s):

OscarJ Benavidez ◽

Ashwin Prakash ◽

Kimberlee Gauvreau ◽

Tal Geva

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Steady State ◽

Diagnostic Accuracy ◽

Congenital Heart ◽

Steady State Free Precession ◽

Cardiac Valve ◽

Free Precession ◽

Valve Morphology ◽

Free Precession Imaging

Download Full-text

Diagnostic Accuracy of Three-dimensional Turbo Field Echo Magnetic Resonance Imaging Sequence in Pediatric Tracheobronchial Anomalies with Congenital Heart Disease

Scientific Reports ◽

10.1038/s41598-018-20892-2 ◽

2018 ◽

Vol 8 (1) ◽

Cited By ~ 1

Author(s):

QiaoRu Hou ◽

Wei Gao ◽

YuMin Zhong ◽

AiMin Sun ◽

Qian Wang ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Congenital Heart Disease ◽

Heart Disease ◽

Magnetic Resonance ◽

Diagnostic Accuracy ◽

Congenital Heart ◽

Three Dimensional ◽

Resonance Imaging ◽

Imaging Sequence ◽

Turbo Field Echo

Download Full-text

Heart Murmur and Physical Examination in Athletes with a Focus on Congenital Heart Disease

Current Sports Medicine Reports ◽

10.1097/01.csmr.0000465141.93617.90 ◽

2015 ◽

Vol 14 (3) ◽

pp. 263-265 ◽

Cited By ~ 1

Author(s):

George K. Lui ◽

Fahad Al Sindi ◽

Ami B. Bhatt

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Physical Examination ◽

Congenital Heart ◽

Heart Murmur

Download Full-text

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

Journal of Nanomaterials ◽

10.1155/2021/9962950 ◽

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.

Download Full-text

A Novel Virtual Reality Medical Image Display System for Group Discussions of Congenital Heart Disease: Development and Usability Testing (Preprint)

10.2196/preprints.20633 ◽

2020 ◽

Author(s):

Byeol Kim ◽

Yue-Hin Loke ◽

Paige Mass ◽

Matthew R Irwin ◽

Conrad Capeland ◽

...

Keyword(s):

Congenital Heart Disease ◽

Virtual Reality ◽

Heart Disease ◽

Diagnostic Accuracy ◽

Congenital Heart ◽

Medical Images ◽

Display System ◽

Group Discussions ◽

Medical Trainees ◽

Display Systems

BACKGROUND The complex 3-dimensional (3D) nature of anatomical abnormalities in congenital heart disease (CHD) necessitates multidisciplinary group discussions centered around the review of medical images such as magnetic resonance imaging. Currently, group viewings of medical images are constrained to 2-dimensional (2D) cross-sectional displays of 3D scans. However, 2D display methods could introduce additional challenges since they require physicians to accurately reconstruct the images mentally into 3D anatomies for diagnosis, staging, and planning of surgery or other therapies. Virtual reality (VR) software may enhance diagnosis and care of CHD via 3D visualization of medical images. Yet, present-day VR developments for medicine lack the emphasis on multiuser collaborative environments, and the effect of displays and level of immersion for diagnosing CHDs have not been studied. OBJECTIVE The objective of the study was to evaluate and compare the diagnostic accuracies and preferences of various display systems, including the conventional 2D display and a novel group VR software, in group discussions of CHD. METHODS A total of 22 medical trainees consisting of 1 first-year, 10 second-year, 4 third-year, and 1 fourth-year residents and 6 medical students, who volunteered for the study, were formed into groups of 4 to 5 participants. Each group discussed three diagnostic cases of CHD with varying structural complexity using conventional 2D display and group VR software. A group VR software, Cardiac Review 3D, was developed by our team using the Unity engine. By using different display hardware, VR was classified into nonimmersive and full-immersive settings. The discussion time, diagnostic accuracy score, and peer assessment were collected to capture the group and individual diagnostic performances. The diagnostic accuracies for each participant were scored by two experienced cardiologists following a predetermined answer rubric. At the end of the study, all participants were provided a survey to rank their preferences of the display systems for performing group medical discussions. RESULTS Diagnostic accuracies were highest when groups used the full-immersive VR compared with the conventional and nonimmersive VR (χ22=9.0, P=.01) displays. Differences between the display systems were more prominent with increasing case complexity (χ22=14.1, P<.001) where full-immersive VR had accuracy scores that were 54.49% and 146.82% higher than conventional and nonimmersive VR, respectively. The diagnostic accuracies provided by the two cardiologists for each participant did not statistically differ from each other (t=–1.01, P=.31). The full-immersive VR was ranked as the most preferred display for performing group CHD discussions by 68% of the participants. CONCLUSIONS The most preferred display system among medical trainees for visualizing medical images during group diagnostic discussions is full-immersive VR, with a trend toward improved diagnostic accuracy in complex anatomical abnormalities. Immersion is a crucial feature of displays of medical images for diagnostic accuracy in collaborative discussions.

Download Full-text