Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-28T09:27:56.816Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  01 April 2015

Adziri H. Sackey
Adziri H. Sackey*
Affiliation:
Department of Child Health, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana
*
Correspondence to: A. H. Sackey, Senior Lecturer, Department of Child Health, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, P. O. Box 4236, Accra, Ghana. Tel: 00233541725324; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

This 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.

Keywords

Paediatriciansasymptomatic heart murmurechocardiography
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 3 , March 2016 , pp. 446 - 450
Check for updates
Copyright
© Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Danford, DA, Martin, AB, Fletcher, SE, Gumbiner, CH. Echocardiographic yield when innocent murmur seems likely but doubts linger. Pediatr Cardiol 2002; 23: 410–414.Google Scholar
2. Karuppaswamy, V, Kelsall, W. Review of paediatric cardiology services in district general hospitals in United Kingdom. Arch Dis Child 2009; 94: 327.Google Scholar
3. Gladman, G. Management of asymptomatic heart murmurs. Paediatr Child Health 2013; 23.2: 64–68.Google Scholar
4. Khushu, A, Kelsall, AW, Usher-Smith, JA. Outcome of children with heart murmurs referred from general practice to a paediatrician with expertise in cardiology. Cardiol Young 2015; 25: 123–127.Google Scholar
5. Hansen, LK, Birkebaek, NH, Oxhøj, H. Initial evaluation of children with heart murmurs by the non-specialized paediatrician. Eur J Pediatr 1995; 154: 15–17.Google Scholar
6. Pushparajah, K, Garvie, D, Hickey, A, Qureshi, SA. Managed care network for the assessment of cardiac problems in a district general hospital: a working model. Arch Dis Child 2006; 91: 892–895.Google Scholar
7. Smythe, JF, Teixeira, OHP, Vlad, P, Demers, PP, Feldman, W. Initial evaluation of heart murmurs: are laboratory tests necessary? Pediatrics 1990; 86: 497–500.Google Scholar
8. Tybulewicz, Rigby ML, Redington, AN. Open access paediatric echocardiography: changing role and referral patterns to a consultant-led service in a tertiary referral centre. Heart 1996; 75: 632–634.Google Scholar
9. McCrindle, BW, Shaffer, KM, Kan, JS, et al. Cardinal clinical signs in the differentiation of heart murmurs in children. Arch Pediatr Adolesc Med 1996; 150: 169–174.Google Scholar
10. Murugan, SJ, Thomson, JDR, Parsons, JM, et al. New outpatient referrals to a tertiary paediatric cardiology centre: increasing workloads and evolving patterns of referral. Cardiol Young 2005; 15: 43–46.CrossRefGoogle Scholar
11. Allen, J, Dickinson, DF, Ramachandran, A, Thomson, JD. Development of a cardiac technician led paediatric echocardiographic service--experience from a district general hospital in the United Kingdom. Cardiol Young 2005; 15: 299–301.CrossRefGoogle ScholarPubMed
12. Marienfeld, CJ, Teles, N, Silvera, J, et al. A 20-year follow-up of ‘innocent’ murmurs. Paediatrics 1962; 30: 42–48.Google Scholar
13. Frank, JE, Jacobe, KM. Evaluation and management of heart murmurs in children. Am Fam Physician 2011; 84: 793–800.Google Scholar
14. Al Harbi, B, Al Akhfash, AA, Al Ghamdi, A, et al. Safety and usefulness of outreach clinic conducted by pediatric echosonographers. Ann Pediatr Cardiol 2012; 5: 165–168.Google Scholar
15. Dowie, RI, Mistry, H, Rigby, M, et al. A paediatric telecardiology service for district hospitals in south-east England: an observational study. Arch Dis Child 2009; 94: 273–277.Google Scholar
16. Yi, MS, Kimball, TR, Tsevat, J, Mrus, JM, Kotagal, UR. Evaluation of heart murmurs in children: cost-effectiveness and practical implications. J Pediatr 2002; 141: 504–511.CrossRefGoogle ScholarPubMed