Clinical diagnosis of congenital and acquired heart disease in children: Do non paediatrician doctors feel competent?

Background: The diagnosis of congenital and acquired heart disease is almost always first clinical, before confirmation by ancillary investigations by the specialist paediatricians to whom these patients are usually referred. Since early diagnosis and appropriate intervention is the only hope for such children, inability to pick up these children on clinical examination with their usual peculiar clinical features and murmurs connotes a disaster for such children.

Objective: To determine if non paediatrician doctors in the Delta state of Nigeria possess the confidence to make clinical diagnoses of congenital or acquired heart disease in children.

Method: An anonymous structured questionnaire was administered to 116 doctors randomly selected from the estimated 600 doctors in both private and public sectors of the Delta state.

Results: Sixty nine (59.5%) have attempted to diagnose congenital or acquired heart disease by identifying a murmur whilst 47 (40.5%) have never made such an attempt. Forty six (40%) feel confident in making a clinical diagnosis after examining the child, while 70 (60%) do not feel confident to make such a diagnosis from clinical examination. Twenty nine (37.7%) blame their inadequate undergraduate training / clinical exposure for their lack of confidence, 40 (51.9%) believe such diagnosis is reserved to specialist paediatricians while 8 (10.4%) could not give any specific reasons for their lack of confidence to make such diagnosis.

Conclusion:Only 40% of non paediatrician doctors in the Delta state of Nigeria feel confident of diagnosing congenital or acquired heart disease in children.