Abstract
Introduction: There is a paucity in the literature of prospective studies on neonatal heart murmurs and their correlation with the diagnostic yield on 2D echocardiography. Objectives: To assess the prevalence of cardiac murmurs in neonates and their significance using 2D Echocardiography/Colour Doppler. Method: A prospective descriptive analytical study was carried out on 100 term neonates admitted to the neonatal intensive care unit (NICU) of a tertiary level hospital from April - November 2017 with audible systolic (grade 2/6 or above), diastolic (2/4 or above) or continuous murmurs. These patients were evaluated with a detailed 2D Echocardiogram /Colour Doppler on portable Sonosite / Epiq using an 8-12 Hz probe. Patient with isolated small patent foramen ovale ( Results: Of the 100 neonates with murmur, 65 (65%) had significant structural defects and 35 (35%) had no structural heart defects. The mean hospital stay was 13.03 days. Seventy five (75%) neonates had good outcome and 25 (25%) had poor outcome in the form of prolonged NICU stay and mortality. Of the 100 neonates without murmur, 97 (97%) had good outcome and 3 (3%) had poor outcome due to non-cardiac issues. Conclusions: The prevalence of murmurs among neonates was 6.2 per 1,000 live births in inborn deliveries (excluding previously diagnosed cases). Complex structural abnormalities were found in 28% of neonates with murmurs. The rest had isolated lesions or single structural lesions such as VSD (19%), PDA (18%) or ASD (2%).
Highlights
There is a paucity in the literature of prospective studies on neonatal heart murmurs and their correlation with the diagnostic yield on 2D echocardiography.deliveries
The prevalence of murmurs among neonates was 6.2 per 1,000 live births in inborn 1Department of Paediatric Cardiology, B J Wadia Hospital for Children, Mumbai, Maharashtra, India *Correspondence: drprashantbhadane@gmail.com (Received on 04 March 2018: Accepted after revision on 20 April 2018) The authors declare that there are no conflicts of interest Personal funding was used for the project
Open Access Article published under the Creative
Summary
There is a paucity in the literature of prospective studies on neonatal heart murmurs and their correlation with the diagnostic yield on 2D echocardiography.deliveries (excluding previously diagnosed cases). There is a paucity in the literature of prospective studies on neonatal heart murmurs and their correlation with the diagnostic yield on 2D echocardiography. Complex structural abnormalities were found in 28% of neonates with murmurs. The rest had isolated lesions or single structural lesions such as VSD (19%), PDA (18%) or ASD (2%). Congenital heart disease (CHD) has an incidence of around 0.8-1 per 1000 live births globally[1,2]. Ultrasound scanning during pregnancy and postnatal clinical examination have a low rate of CHD detection[4,5,6]. Routine clinical examination diagnoses less than 50% of the children with CHD5. Electrocardiography (ECG) and chest x-ray contribute little to diagnosis of heart murmurs[7,8,9].
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