Significance of Cardiac Murmurs in Symptomatic and Asymptomatic Neonates by Correlation with Echocardiogram.

Varghese, Lea; Avabratha, K. Shreedhara; Fernandes, Deepthi Joella

Introduction: Congenital heart disease (CHD), one of the commonest congenital anomaly in neonates, might result in adverse neonatal outcome if not detected and treated on time. Clinically, these neonates may present with murmurs. Neonatal physical examination aided by echocardiography has improved diagnostic yield. Methods: A descriptive observational study was conducted over 18 months in a medical college hospital in Mangalore, India. Neonates with murmurs during their routine clinical examination or on follow up visits within the first 28 days of life were enrolled. Subsequently, they were categorized based on whether the symptoms were present or absent. Echocardiograms were performed by a paediatric cardiologist within 24 hours of the detection of murmurs and were correlated with the murmur and clinical features. Results: The study identified cardiac murmurs in 70 (3.7%) out of 1880 neonates examined. Ejection systolic murmurs were predominant (71.4%) and commonly detected within the first two days (67.1%). Sixty percent of the neonates were symptomatic. Echocardiography revealed significant CHD in 30% of symptomatic and 5.7% of asymptomatic neonates. Symptomatic neonates at presentation were twice as likely to exhibit abnormal echocardiograms (Odds ratio: 2.071, with 95% confidence interval: 0.36-4.79), and additional physical examination features tripled the likelihood of abnormal echocardiograms (Odds ratio: 3.187, with 95% confidence interval: 1.542-6.612). Conclusions: Cardiac murmurs were observed in 3.7% of neonates. In addition to murmurs, those who were symptomatic increased the likelihood of having CHD. Therefore, symptomatic neonates need cardiac evaluation before discharge.

HEART murmurs; CONGENITAL heart disease; NEWBORN infants; ECHOCARDIOGRAPHY; ODDS ratio

Journal of Nepal Paediatric Society, 2024, Vol 44, Issue 2, p53

1990-7974

Academic Journal

10.60086/jnps1234