Evaluation of heart murmurs in children: One year of observational study

Abstract

Aim: This prospective study aimed to evaluate the heart murmurs and nature of heart disease found among new referral of children at pediatric outpatient clinics of Sohag University hospital. The study depended on Doppler echocardiography as a diagnostic standard for differentiation of heart murmurs and precise evaluation of innocent murmurs. Methods: The study was conducted on 183 patients with heart murmur from 6 weeks to 12 years old for new referral at pediatric outpatient clinics for 1 year. All patients underwent cardiac auscultatory examinations and Doppler echocardiography examination. Results: Of 183 patients, 97 children were males (53.28%). Innocent murmurs were found in 98 patients (53%) and pathological murmurs in 85 patients (47%). The most common pathological murmur is VSD (23%), followed by RHD (MR) (12%). There was no statistically significant difference between innocent and pathological murmurs regarding age, sex, consanguinity and other sibling who had CHD as in Table 3. Conclusions: Several healthy children are referred to pediatric cardiologists or for echocardiographic examination. Physician anxiety is an important reason for a referral of the children to pediatric cardiologists. Echocardiography provides a definitive diagnosis and is recommended for evaluation of any potentially pathologic murmur, and for evaluation of infant heart murmurs because these are more likely to be manifestations of structural heart disease. Cardiac examination should remain the first line diagnostic tool of every clinician; echocardiography should not replace it.

Keywords

• Innocent murmur
• Pathological murmur
• Echocardiography