heart murmur
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2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jan Pavlicek ◽  
Eva Klaskova ◽  
Sabina Kapralova ◽  
Alzbeta Moravova Palatova ◽  
Alicja Piegzova ◽  
...  

Abstract Background Severe or critical congenital heart defects (CHDs) constitute one third of the heart defect cases detected only after birth. These prenatally unrecognised defects usually manifest as cyanotic or acyanotic lesions and are diagnosed postnatally at various times. The aim of the study was to identify their clinical symptoms and determine individual risk periods for CHD manifestation. Methods Data were assessed retrospectively based on a cohort of patients born between 2009 and 2018 in a population of 175,153 live births. Occurrence of the first symptoms of CHD was classified into: early neonatal (0–7 days), late neonatal (8–28 days), early infancy (1–6 months), or late infancy (6–12 months). The first symptom for which the child was referred to a paediatric cardiologist was defined as a symptom of CHD. Results There were 598 major CHDs diagnosed in the studied region, 91% of which were isolated anomalies. A concomitant genetic disorder was diagnosed in 6% of the cases, while 3% presented extracardiac pathology with a normal karyotype. In total, 47% (282/598) of all CHDs were not identified prenatally. Of these, 74% (210/282) were diagnosed as early neonates, 16% (44/282) as late neonates, and 10% (28/282) as infants. The most common symptoms leading to the diagnosis of CHD were heart murmur (51%, 145/282) and cyanosis (26%, 73/282). Diagnosis after discharge from the hospital occurred in 12% (72/598) of all major CHDs. Ventricular septal defect and coarctation of the aorta constituted the majority of delayed diagnoses. Conclusions In conclusion, murmur and cyanosis are the most common manifestations of prenatally undetected CHDs. Although most children with major CHDs are diagnosed as neonates, some patients are still discharged from the maternity hospital with an unidentified defect.


2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S447-S448
Author(s):  
Deniz Akyol ◽  
Gunel Quliyeva ◽  
Selin Bardak özcem ◽  
Meral kayıkçıoğlu ◽  
Tansu Yamazhan ◽  
...  

Abstract Background In this retrospective cohort study, it was aimed to compare the clinical characteristics and outcomes of IE cases without and with an indication for cardiac surgery in terms of whether they have been operated or not, in a tertiary-care educational hospital. Methods Patients that were followed up for definite IE (diagnosed according to modified Duke criteria between March 2007 and November 2020) with an indication for cardiac surgery according to European Society of Cardiology Guidelines, comprised the study group. Subjects were evaluated in terms of whether these cases have been operated or not, demographic features, underlying diseases, risk factors, clinical and laboratory findings, therapy responses, complications, and mortality. The timing of surgery is defined as emergency; surgery performed within 24 hours, urgent; within a few days, elective; after at least one-two weeks of antibiotic therapy. Statistical analysis was performed via Chi square and Student T tests and a p value < 0.05 was considered significant. Results A total of 90 patients with an indication for surgery, 33.3% patients in underwent surgery, 66.6% patients in not underwent surgery group fulfilled the study criteria. The most frequently seen complaints in patients were fever (91.1%), cold-shiver (56.6%), weight-loss (27.7%), dyspnea (25.5%), and tachycardia (20%). Heart murmur was detected during cardiac auscultation of 44 patients. Mean blood leukocyte count, C-reactive protein and erythrocyte sedimentation rate were 12324 ± 6558/mm3 (1408-30330), 11.46 ± 8.38 mg/dl (0.18-34.6) and 61.43 ± 33.4 mm/h (2-130), respectively. There was no significant difference between two groups in terms of cardiac/non-cardiac risk factors, age, gender, etiologic agents, laboratory findings, septic embolisms and complaints (Table 1). In total IE with an indication for surgery mortality was 27.7%. Mortality rate was significantly less and heart murmur was significantly higher in cases who underwent surgery than those did not undergo surgery (p: 0.0447). Table 1. Comparison of basic characteristics of patients in the two operated / unoperated cohorts. Conclusion These data support the importance of the guidelines’ criteria for cardiac surgery in the management of IE. Assuming that only 1/3 of the surgery needing cases received surgery, more interventions are needed to decrease the barriers against surgery. Disclosures All Authors: No reported disclosures


2021 ◽  
pp. 48-51
Author(s):  
Kaldarbek Abdramanov ◽  
◽  
Emilbek Kokoev ◽  
Parida Arzibaeva ◽  
Ayday Abdramanova

Purpose of the study. Study of the prevalence of congenital heart defects among schoolchildren in the Kyrgyz Republic. Materials and methods. The material for the study were 38598 schoolchildren aged 6 to 16 surveyed in Jalal-Abad, Osh, Batken and Naryn regions. Using the instrumental technique, 2919 children out of all schoolchildren underwent an echocardiographic (EchoCG) study. The indication for echocardiography of the study was presence of a heart murmur, revealed by auscultation. Results. Based on the study, the authors identified 171 (5.8%) cases of congenital heart defects. Conclusion. The presented results indicate changes in the size of the heart cavities, valve apparatus and pressure in the pulmonary artery with an enriched pulmonary circulation. With tetralogy of Fallot and pulmonary atresia, there is an increased size of the pancreas and a smaller size of the left ventricle. More complex defects are detected at a younger age. All of the above indicates the need to optimize early diagnosis and management tactics for children with congenital heart defects.


Author(s):  
Prof. Vidyashree K P

Cardiomegaly is an augmented (enlarged) heart. It is not a disease merely a sign of another condition. Cardiomegaly in the early stages, which is less severe, is called mild Cardiomegaly. These complications may give rise to conditions like Blood clots, Cardiac Arrest and sudden death, Heart failure, Heart murmur. Hence, detecting these kinds of states in the early stages helps in improving medications and reduce complications. In this paper, we will present various approaches available to detect this development using Deep learning and offer an automated system to detect the presence of Cardiomegaly in a patient. For the computerized system, we are using deep learning concepts such as U-Net and VGG16 and image enhancement (image prepossessing is required) methods like Unsharp Masking, Contrast Limited Adaptive Histogram, High-Frequency Emphasis Filtering. Accurate measure of CTR (cardiothoracic ratio) calculations can effectively diagnose the presence of Cardiomegaly in a patient.


Methods ◽  
2021 ◽  
Author(s):  
Alisa D. Levin ◽  
Anthony Ragazzi ◽  
Skyler L. Szot ◽  
Taikang Ning
Keyword(s):  

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Kai Chen ◽  
Jiao Wang ◽  
Huihui Zhou ◽  
Xiang Huang

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 ◽  
2021 ◽  
Vol 107 (9) ◽  
pp. 733-770
Author(s):  
Alexander Perry Taylor ◽  
Deanna Hanson ◽  
Eric V Krieger
Keyword(s):  

2021 ◽  
Vol 29 (3) ◽  
pp. 158-170
Author(s):  
Helen Louise Seignior

Background Newborn screening for congenital heart disease (CHD) forms part of the newborn physical examination (NPE) in the UK. However, research has shown that up to 50% of cases of CHD can be missed by this examination. The purpose of this literature review is to investigate the significance of hearing an asymptomatic heart murmur at the NPE in relation to the presence of CHD. Methodology A critical literature review was conducted to answer the research question. The findings were discussed using a narrative synthesis approach. Findings There was considerable heterogeneity of results. The prevalence of murmur in newborns ranged between 0.6%–10.7%. Between 13%–67% of those newborns had some form of CHD, although many had clinically insignificant lesions. Between 2%–9% of newborns with murmurs had a form of critical CHD (CCHD). The ability to discern whether a heart murmur relates to pathology or not improves with experience. No single optimal timing for the NPE was identified. Pulse oximetry was shown to increase sensitivity of screening for CCHD. Conclusion There is a significant increase in the prevalence of CHD when a newborn has a heart murmur, hence referral for diagnostic echocardiography is required when a heart murmur is identified. Pulse oximetry is an important adjunct to newborn screening for CCHD. Some newborns affected by CCHD will not present with murmur at the NPE. Therefore, those caring for newborns during the early days must know the signs and symptoms of CHD so that appropriate medical assistance can be sought.


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247588
Author(s):  
Yousuke Taniguchi ◽  
Kenichi Sakakura ◽  
Yohei Nomura ◽  
Masashi Hatori ◽  
Kaho Shibata ◽  
...  

Careful auscultation is the first step to diagnose aortic stenosis (AS). The aim of this study was to compare clinical outcomes following transcatheter aortic valve implantation (TAVI) between the patients primarily diagnosed by heart murmur and those diagnosed by other reasons. We retrospectively included 258 patients who underwent TAVI in our medical center, and divided those into the murmur group (n = 81) and the other-reason group (n = 177) according to the primary reason for AS diagnosis. The primary endpoint was the major adverse cardiovascular and cerebrovascular events (MACCE), which was defined as the composite of cardiovascular death, hospitalization due to acute decompensated heart failure, and disabling stroke. The murmur group included younger patients than the other-reason group (82.8 year-old vs. 84.0 year-old, P = 0.02). History of AF was more frequently observed in the other-reason group than in the murmur group (21.5% vs. 7.4%, P <0.01). STS score and logistic EuroSCORE were lower in the murmur group than in the other-reason group (STS: 4.7% vs. 7.2%, P <0.01, logistic EuroSCORE: 8.3% vs. 11.2%, P <0.01). The median follow-up period was 562 days. MACCE was more frequently observed in the other-reason group than in the murmur group (27.7% vs. 9.9%, Log Rank P <0.01). The multivariate COX hazard analysis revealed that the AS patients primarily diagnosed by heart murmur was inversely associated with MACCE (HR 0.38, 95%CI 0.17–0.86, P = 0.020). Among AS patients who underwent TAVI, the patients primarily diagnosed by heart murmur were significantly associated with favorable long-term clinical outcomes.


Sensors ◽  
2021 ◽  
Vol 21 (4) ◽  
pp. 1376
Author(s):  
Kiichi Takahashi ◽  
Kyoichi Ono ◽  
Hirokazu Arai ◽  
Hiroyuki Adachi ◽  
Masato Ito ◽  
...  

This study aimed to evaluate the capability of a piezoelectric sensor to detect a heart murmur in patients with congenital heart defects. Heart sounds and murmurs were recorded using a piezoelectric sensor and an electronic stethoscope in healthy neonates (n = 9) and in neonates with systolic murmurs caused by congenital heart defects (n = 9) who were born at a hospital. Signal data were digitally filtered by high-pass filtering, and the envelope of the processed signals was calculated. The amplitudes of systolic murmurs were evaluated using the signal-to-noise ratio and compared between healthy neonates and those with congenital heart defects. In addition, the correlation between the amplitudes of systolic murmurs recorded by the piezoelectric sensor and electronic stethoscope was determined. The amplitudes of systolic murmurs detected by the piezoelectric sensor were significantly higher in neonates with congenital heart defects than in healthy neonates (p < 0.01). Systolic murmurs recorded by the piezoelectric sensor had a strong correlation with those recorded by the electronic stethoscope (ρ = 0.899 and p < 0.01, respectively). The piezoelectric sensor can detect heart murmurs objectively. Mechanical improvement and automatic analysis algorithms are expected to improve recording in the future.


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