A study on clinical and echocardiographic evaluation of neonatal cardiac murmurs and their follow up at 6 weeks of age
Abstract
Background: The echocardiogram permits early accurate anatomical diagnosis either to reassure parents that the heart was normal, or to detect a heart disease and explain the nature of the abnormality and make an early referral for definitive treatment.
Aim: Assessment of neonatal cardiac murmurs clinically and by echocardiogram at birth and at 6 weeks of age.
Materials and Methods: A prospective longitudinal study was conducted on neonates for a period of one year at Government Mohan Kumaramangalam Medical College Hospital, Salem. Cardiac murmur was graded between 1 and 6 based on the intensity of the murmur. All neonates underwent an echocardiographic examination by Cardiologists at 1st week and later at 6 weeks.
Results: The incidence of murmur in the first week of life was 23/1000 live births and the incidence of congenital heart disease was 12.6/1000 live births and at 6 weeks it was 6.6/1000 live births. The most common congenital heart disease during the 1st week examination was found to be VSD, followed by ASD and PDA. Identifying a pathological murmur and its association with structural congenital heart disease was found to be statistically significant (p<.05), whereas identifying an innocent murmur and its association with a normal heart did not show a statistical significance and so it infers that all the innocent murmurs has to be followed up with a echocardiogram to rule out structural heart disease in the neonates.
Conclusion: It is important to evaluate all neonatal cardiac murmurs with echocardiogram before they become symptomatic.
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