Home Print this page Email this page Small font sizeDefault font sizeIncrease font size
Users Online: 926
 
About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Advertise Login 
     
ORIGINAL ARTICLE
Year : 2016  |  Volume : 5  |  Issue : 3  |  Page : 174-178

Innocent versus pathologic murmurs: A challenge of neonatal examination


1 Department of Pediatrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

Correspondence Address:
Dr. Mohammad Reza Khalilian
Department of Pediatrics, Shahid Beheshti University of Medical Sciences, Tehran
Iran
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4847.191254

Rights and Permissions

Objective: Auscultation is one of the most important procedures in routine examination of neonates for congenital heart disease (CHD). Differentiating between innocent and pathologic murmurs during auscultation is very hard and usually unfeasible. The aim of this study was to assess the ability of clinical examination in comparison to echocardiographic examination to differentiate innocent from pathological murmurs and also to define the prevalence of heart murmurs in neonates. Materials and Methods: In the current cross-sectional study, 7113 neonates were examined in a period of 1 year by two neonatologists. If heart murmurs or unnatural sounds were auscultated during the examination, the observations were categorized as "probably pathologic" or "probably innocent" and the neonates were then referred to a pediatric cardiologist for echocardiography. Results: Prevalence of heart murmurs was found to be 19.26 for every thousand live births. According to the clinical examinations, 55% of murmurs were categorized as innocent and 45% as pathologic. Echocardiographic results revealed that in fact 50.8% of cases were either normal or had physiological defects and 49.2% were pathologic. Sensitivity, specificity, positive predictive value, and negative predictive value of clinical examination in differentiating between innocent and pathologic murmurs were found to be 79.7%, 88.5%, 87%, and 81.8%, respectively, and the false-positive and false-negative rates were found to be 11.5% and 20.3%, respectively. Conclusion: Although these numbers show that clinical examination is adequate for differentiating between innocent murmurs and CHD, however the false-positive and false-negative rates in clinical examination, stress that echocardiography must be performed for a better CHD diagnosis.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
  Search Pubmed for
  Search in Google Scholar for
Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed5625    
    Printed28    
    Emailed0    
    PDF Downloaded420    
    Comments [Add]    

Recommend this journal