An appraisal of infants with murmurs referred to a cardiac clinic

Objective: Appraisal of infants with murmurs referred to a cardiac clinic.

 Method: Retrospective analysis of all infants with newly heard murmurs referred from April 2007 to October 2009 to cardiac clinics run by a paediatrician with special expertise in cardiology in the City Hospital and Sandwell General Hospital in the West Midland, UK..

 Results: During the study period, 246 infants were referred for murmurs. Of the referrals 55% were following postnatal checks and 45% from paediatric clinics and general practitioners. All infants had clinical examinations, saturation checks and electrocardiograms. Echocardiograms were done when needed. In 88 (36%) infants no murmurs were heard during assessment and no follow-up was needed. In 158 (64%) infants murmurs were heard during assessment.  Fifty four (34%) infants with innocent murmurs and normal echocardiograms were discharged from the clinic. All 13 (8%) infants with patent foramen ovale (PFO) showed closure of PFO on subsequent follow up. Cardiac defects (excluding PFO) were found on echocardiogram in 91 (58%) infants. Of the 91 infants 24 (26%) with significant cardiac defects were referred to the nearest tertiary cardiac centre for further management.  

 Conclusions: The prevalence of murmurs detected at routine neonatal examination was 0.7%. Fifty eight percent of infants with murmurs had cardiac defects 26% of which were significant.

 (Key words: Cardiac murmurs; infants; appraisal)

Sri Lanka Journal of Child Health, 2011; 40(3): 125-127

DOI: http://dx.doi.org/10.4038/sljch.v40i3.3510  (This DOI was corrected on 4/11/2011 so please use this version to refer to this article)