PREVALENCE AND CLINICAL SIGNIFICANCE OF CARDIAC MURMURS IN NEONATES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 89
Abstract
BACKGROUND 5 to 8 in every 1000 live born babies have a cardiovascular malformation which presents in infancy, but most are asymptomatic at birth. The diagnosis is established only in 50% of cases by 1 month of age. The difficulties in detecting heart disease at neonatal examination are well known. There are very few studies done so far in developing countries like India in this field. Until preventive measures become available, reduction of infant mortality due to congenital cardiovascular malformations will continue to depend on early recognition of symptoms and signs of serious heart disease in infants and on effective community-wide use of specialised cardiac services. MATERIALS AND METHODS Approximately, 1000 infants up to 6 weeks of age were enrolled in study after consent. After echocardiography evaluation subjects with murmur are classified into structurally significant heart lesions, structurally insignificant heart lesions and normal echocardiogram findings. Patent foramen ovale (< 3 mm), peripheral pulmonary artery stenosis, small patent ductus arteriosus (<2 mm) are classified as structurally insignificant heart lesions. Structurally significant heart lesions are further classified into different congenital heart diseases to establish clinical significance of murmurs. RESULTS Prevalence of cardiac murmurs during routine neonatal clinical examination was 3.9%. Prevalence of structurally significant heart disease among cases of murmur was 66%. Out of remaining 34% cases, 21% had structurally insignificant heart disease and 13% had normal heart. Family history, significant maternal history, consanguinity and dysmorphic features were statistically significant predictors of underlying structurally significant heart lesions. Early cardiac intervention was required for 16% cases of structurally significant heart disease. CONCLUSION Unrecognised neonatal heart disease carries a serious risk of avoidable mortality, morbidity and handicap. Early detection of murmur and intervention is important to prevent worsening and complications in cases of congenital heart disease.
Authors and Affiliations
Kumbhojkar A. P
Keywords
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- EP ID EP277974
- DOI 10.14260/jemds/2017/1354
- Views 78
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