Accuracy of the Initial Evaluation of Heart Murmurs in Neonates: Do We Need an Echocardiogram?

Azhar, A. S.; Habib, H. S.
March 2006
Pediatric Cardiology;Mar/Apr2006, Vol. 27 Issue 2, p234
Academic Journal
The objective of this study was to determine the differences between neonatologists and pediatric cardiologists with regards to the initial assessment of neonatal heart murmur and to evaluate the role of echocardiography in this group of patients. During a period of 1 year, all neonates with heart murmur seen in pediatric cardiology consultation from neonatal intensive care units at the Children Hospital of Eastern Ontario and Ottawa General Hospital were included in this study. Neonates with heart murmur were initially evaluated clinically by a neonatologist and the most likely clinical diagnosis was recorded. This was followed by similar evaluation and assessment by the pediatric cardiologist, who did not know the result of the previous assessment. Echocardiography diagnosis was considered the gold standard for the accurate diagnosis in the two groups, and it was done for all patients. For the neonatologists, the sensitivity to detect a pathological murmur was 78% and the specificity was 33%; the positive predictive value was 77% and the negative predictive value was 37%. For the pediatric cardiologists, the accuracy of the clinical examination showed a sensitivity of 83% in detecting a pathological murmur and a specificity of 25%; the positive predictive value was 80% and the negative predictive value was 29%. There was no significant difference between the two groups. Certified neonatologists are able to assess the significance of neonatal heart murmurs well as pediatric cardiologists, although echocardiogram is still needed to reach the accurate diagnosis of congenital heart disease in neonates even if a pediatric cardiologist is consulted.


Related Articles

  • Estudio de los soplos cardíacos en edad pediátrica. Flores-Torres, Laura Georgina; Garrido-García, Luis Martín // Acta Pediatrica de Mexico;sep/oct2012, Vol. 33 Issue 5, p252 

    Heart murmurs are one of the most common pediatric cardiology referrals. In 50-85% of patients the murmur is innocent and it should be differentiate of congenital or acquired heart diseases. In the majority of the cases a complete clinical history and a physical examination are sufficient to...

  • Utility of Hand-Held Echocardiography in Outpatient Pediatric Cardiology Management. Riley, Alan; Sable, Craig; Prasad, Aparna; Spurney, Christopher; Harahsheh, Ashraf; Clauss, Sarah; Colyer, Jessica; Gierdalski, Marcin; Johnson, Ashley; Pearson, Gail; Rosenthal, Joanna // Pediatric Cardiology;Dec2014, Vol. 35 Issue 8, p1379 

    Adult patient series have shown hand-held echocardiography (echo) units (HHE) to be accurate for rapid diagnosis and triage. This is the first study to evaluate the ability of HHE to inform decision making in outpatient pediatric cardiology. New pediatric cardiology patients in outpatient...

  • Comparative Study of Clinical Evaluation of Heart Murmurs by General Pediatricians and Pediatric Ca. Rajakumar, Kumaravel; Weisse, Martin // Clinical Pediatrics;Sep1999, Vol. 38 Issue 9, p511 

    Summary: In a study to compare the clinical diagnostic skills of academic general pediatricians and academic pediatric cardiologists in the evaluation of heart murmurs, a total of 128 patients (aged 1 month to 18 years) newly referred to a university pediatric cardiology clinic were evaluated by...

  • Outcome of children [corrected] with heart murmurs referred from general practice to a paediatrician with expertise in cardiology. Khushu, Abha; Kelsall, Anthony W.; Usher-Smith, Juliet A. // Cardiology in the Young;Jan2015, Vol. 25 Issue 1, p123 

    Background: Heart murmurs are common in children. The majority are detected incidentally, and congenital heart disease is rare. There are no published United Kingdom guidelines for management of children with murmurs in primary care. Common practice is to refer all children for...

  • Heart Murmurs in Infants, Children, and Adolescents. Frank, Jennifer // Pediatrics for Parents;Sep/Oct2011, Vol. 27 Issue 9/10, p13 

    The article offers information related to heart murmurs which have higher risk related to underlying heart disease in newborns and infants than in older children and adolescents. It says that the pediatric cardiologist can perform an echocardiogram if the sound of the murmur during the test is...

  • Pediatric cardiology in India: Onset of a new era. Kumar, Dinesh; Bagri, Narendra // Indian Pediatrics;Jul2015, Vol. 52 Issue 7, p563 

    Pediatric cardiology is outgrowing from the shadows of adult cardiology and cardiac surgery departments in India. It promises to be an attractive and sought-after subspeciality of Pediatrics, dealing with not only congenital cardiac diseases but also metabolic, rheumatic and host of other...

  • Effectiveness of Teaching Cardiac Auscultation to Residents During an Elective Pediatric Cardiology Rotation. Mattioli, Leone F.; Belmont, John M.; Davis, Ann McGrath // Pediatric Cardiology;Nov2008, Vol. 29 Issue 6, p1095 

    This study aimed to assess the effectiveness of randomized tracks of prerecorded cardiac sounds as a teaching tool for cardiac auscultation. The study focused on recognizing murmurs when present, distinguishing functional from organic murmurs, and detecting heart disease by auscultation. At both...

  • The 64-Multislice Computed Tomogram Averts Misdiagnosis of an Anomalous Origin of the Left Main Coronary Artery. Jebelli, Mohammad; Kernstine, Kemp; Mandegar, Mohammad Hossein; Sarzaeem, Mahmood Reza; Rayatzadeh, Hussein // Pediatric Cardiology;Nov2009, Vol. 30 Issue 8, p1184 

    A 38-year-old woman was discovered to have a systolic murmur for an unrelated complaint. Transesophageal echocardiography showed no atrial or ventricular septal defects, but multiple large collateral vessels in inter-ventricular septum. The origin of left coronary artery was not seen at the...

  • Partial Anomalous Pulmonary Venous Return to the Azygos Vein: An Unusual Case. Lapierre, Chantale; Siles, Ana; Bigras, Jean-Luc // Pediatric Cardiology;Jul2010, Vol. 31 Issue 5, p749 

    The article presents a case study of 13-year-old boy with heart murmur who was referred for cardiac evaluation. It states that the patients had good health but has a history of recurrent pulmonary infection. The patient undergone several examinations including chest radiography, transthoracic...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics