G417(P) Outcomes of postnatal ward heart murmurs at a tertiary neonatal unit with a paediatrician with expertise in cardiology

Abstract

Background Heart murmurs are commonly detected at the Newborn Infant Physical Examination (NIPE). Routine use of antenatal and pulse oximetry screening means isolated murmurs are unlikely to be due to missed critical Congenital Heart Disease (CHD). We have developed a local guideline for assessment and follow up of these babies and share our experience of this service. Aim To assess the outcomes of neonatal heart murmurs detected on routine NIPE and review utilisation of neonatal and PEC (Paediatrician with Expertise in Cardiology) clinics. Methods All babies with murmurs on NIPE over one year (July 2015–June 2016) were retrospectively identified from the NIPE Smart system. Data was gathered from electronic and paper hospital records. All babies had follow-up outcomes for minimum 6 months. Babies with antenatal CHD diagnosis or having NICU admission were excluded. Results Out of about 6000 deliveries, 139 patients had murmurs detected (50.4% Male). 96 murmurs were noted at Conclusion Most murmurs in neonates with normal pulse-oximetry are innocent, only 4% diagnosed with underlying CHD. CXR and ECGs have little role in the routine investigation of isolated neonatal murmurs. The current department referral pathway is working well with only 10% of referrals to neonatal clinic requiring PEC clinic referral, thus optimising PEC clinic utilisation.