Document Detail


Reappraisal of the approach to the child with heart murmurs: is echocardiography mandatory?
MedLine Citation:
PMID:  3372064     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The performance of cross-sectional echocardiography on every child with a heart murmur poses a heavy load and economic burden on pediatric cardiology services. We prospectively studied 100 consecutive patients newly referred to our clinic for evaluation of a heart murmur. After a thorough clinical assessment and review of the electrocardiogram and chest radiograms, 50 patients were diagnosed as having "innocent murmurs". Cross-sectional echocardiography confirmed the initial diagnosis in 48 patients (96%). Two patients had bicuspid aortic valve. Among the patients with echocardiographically proved innocent murmur, left ventricular anomalous bands were demonstrated in 15 patients (31%), right ventricular anomalous bands in 5 patients (10%) and increased left ventricular shortening fractions (greater than or equal to 0.5) in 10 patients (21%). Among the remaining 50 patients, the initial diagnosis was "suspected heart disease" in 10 patients, and "pathological murmurs" in 40 patients. Cross-sectional echocardiography was most useful in these patients providing the diagnosis in 80% (eight) of the former group and 95% (38) of the later group. Echocardiography need not be routinely performed in children initially diagnosed, by a pediatric cardiologist, as having an "innocent murmur".
Authors:
T Geva; J Hegesh; M Frand
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  19     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  1988 Apr 
Date Detail:
Created Date:  1988-07-14     Completed Date:  1988-07-14     Revised Date:  2006-07-12    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  107-13     Citation Subset:  IM    
Affiliation:
Department of Pediatrics C, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Aortic Valve Stenosis / diagnosis
Child
Child, Preschool
Ductus Arteriosus, Patent / diagnosis
Echocardiography*
Female
Heart Auscultation / classification*
Heart Murmurs / classification*
Heart Septal Defects, Atrial / diagnosis
Heart Septal Defects, Ventricular / diagnosis
Humans
Infant
Male
Predictive Value of Tests
Prospective Studies
Pulmonary Valve Stenosis / diagnosis
Tetralogy of Fallot / diagnosis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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