Register for email alerts and news feeds:
This journal | BMJ Group
rss
Archives of Disease in Childhood - Fetal and Neonatal Edition 1999;80:F43-F45; doi:10.1136/fn.80.1.F43
Copyright © 1999 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.
Arch Dis Child Fetal Neonatal Ed 1999;80:F43-F45 ( January )

Prevalence and clinical significance of cardiac murmurs in neonates

Sean B Ainsworth,a Jonathan P Wyllie,a Christopher Wrenb

a Directorate of Neonatology South Cleveland Hospital Middlesbrough TS4 3BW, b Department of Paediatric Cardiology Freeman Hospital Newcastle upon Tyne

Correspondence to: Dr J P Wyllie.


Accepted 26 June 1998

AIM---To determine the prevalence and clinical significance of murmurs detected during routine neonatal examination.
METHODS---In a two year prospective study, 7204 newborn babies underwent routine examination by senior house officers. All those with murmurs underwent echocardiographic examination. All babies presenting later in infancy were also identified, to ascertain the total prevalence of congenital heart disease in infancy.
RESULTS---Murmurs were detected in 46 babies (0.6%) of whom 25 had a cardiac malformation. The most common diagnosis was a ventricular septal defect, although four babies had asymptomatic left heart outflow obstruction. A further 32 infants from the same birth cohort had a normal neonatal examination but were found to have a cardiac malformation before 12 months of age.
CONCLUSIONS---The neonatal examination detects only 44% of cardiac malformations which present in infancy. If a murmur is heard there is a 54% chance of there being an underlying cardiac malformation. Parents and professionals should be aware that a normal neonatal examination does not preclude a clinically significant cardiac malformation. The detection of a murmur should prompt early referral to a paediatric cardiologist for diagnosis or appropriate reassurance.

Key messages

  • The prevalence of murmurs detected at routine examination of neonates is less than 1%.
  • About half of murmurs are due to an underlying cardiovascular malformation
  • Early referral of all newborn babies with murmurs for definitive diagnosis is recommended
  • The absence of a murmur does not exclude serious heart disease



Keywords: congenital heart disease; neonatal examination; cardiac murmur; screening

© 1999 by Archives of Disease in Childhood
Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?

This article has been cited by other articles:

  • Chang, R.-K. R., Gurvitz, M., Rodriguez, S. (2008). Missed Diagnosis of Critical Congenital Heart Disease. Arch Pediatr Adolesc Med 162: 969-974 [Abstract] [Full Text]  
  • Sellwood, M, Huertas-Ceballos, A (2008). Review of NICE guidelines on routine postnatal infant care. Arch. Dis. Child. Fetal Neonatal Ed. 93: F10-F13 [Full Text]  
  • Valmari, P. (2007). Should pulse oximetry be used to screen for congenital heart disease?. Arch. Dis. Child. Fetal Neonatal Ed. 92: F219-F224 [Abstract] [Full Text]  
  • Patton, C, Hey, E (2006). How effectively can clinical examination pick up congenital heart disease at birth?. Arch. Dis. Child. Fetal Neonatal Ed. 91: F263-F267 [Abstract] [Full Text]  
  • Levy, H. L., Waisbren, S. E., Guttler, F., Hanley, W. B., Matalon, R., Rouse, B., Trefz, F. K., de la Cruz, F., Azen, C. G., Koch, R. (2003). Pregnancy Experiences in the Woman With Mild Hyperphenylalaninemia. Pediatrics 112: 1548-1552 [Abstract] [Full Text]  
  • Farrer, K F M, Rennie, J M (2003). Neonatal murmurs: are senior house officers good enough?. Arch. Dis. Child. Fetal Neonatal Ed. 88: F147-F151 [Abstract] [Full Text]  
  • Richmond, S, Reay, G, Abu Harb, M (2002). Routine pulse oximetry in the asymptomatic newborn. Arch. Dis. Child. Fetal Neonatal Ed. 87: F83-88 [Abstract] [Full Text]  
  • Wolke, D, Dave, S, Hayes, J, Townsend, J, Tomlin, M (2002). Routine examination of the newborn and maternal satisfaction: a randomised controlled trial. Arch. Dis. Child. Fetal Neonatal Ed. 86: F155-F160 [Abstract] [Full Text]  
  • Lee, T W R, Skelton, R E, Skene, C (2001). Routine neonatal examination: effectiveness of trainee paediatrician compared with advanced neonatal nurse practitioner. Arch. Dis. Child. Fetal Neonatal Ed. 85: F100-104 [Abstract] [Full Text]  
  • Turner, S W, Hunter, S, Wyllie, J P (1999). The natural history of ventricular septal defects. Arch. Dis. Child. 81: 413-416 [Abstract] [Full Text]  

This Article

Services
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.

Latest from ADC

 

ADC is co-owned by the RCPCH and is the official journal of the European Academy of Paediatrics

BMJ Careers - Latest Paediatrics and Paediatric Surgery Jobs

Paediatrics and Paediatric Surgery Jobs

Show me all >>