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Arch Dis Child Fetal Neonatal Ed. Jan 1999; 80(1): F49–F53.
PMCID: PMC1720871

Presentation of congenital heart disease in infancy: implications for routine examination

Abstract

AIM—To investigate the performance of routine neonatal and 6 week examinations for detecting congenital heart disease.
METHODS—A retrospective review of findings on clinical examination was conducted of a cohort of live born infants with congenital heart disease in one health region in 1987-94
RESULTS—Of 1590 babies with congenital heart disease, 523 (33%) presented before neonatal examination because of symptoms or non-cardiac abnormalities. 1061 underwent routine neonatal examination which was abnormal in 476 (45%), but only 170 were referred directly for diagnosis. Of 876 discharged with no diagnosis, 306 presented or died undiagnosed before 6 weeks. At 6 weeks 252 of 569 babies underwent a second routine examination which was abnormal in 164(65%).
CONCLUSIONS—Routine neonatal examination fails to detect more than half of babies with heart disease; examination at 6 weeks misses one third. A normal examination does not exclude heart disease. Babies with murmurs at neonatal or 6 week examinations should be referred for early paediatric cardiological evaluation which will result either in a definitive diagnosis of congenital heart disease or in authoritative reassurance of normal cardiac anatomy and function.

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Selected References

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  • Silove ED. Assessment and management of congenital heart disease in the newborn by the district paediatrician. Arch Dis Child Fetal Neonatal Ed. 1994 Jan;70(1):F71–F74. [PMC free article] [PubMed]
  • Abu-Harb M, Hey E, Wren C. Death in infancy from unrecognised congenital heart disease. Arch Dis Child. 1994 Jul;71(1):3–7. [PMC free article] [PubMed]
  • Mitchell SC, Korones SB, Berendes HW. Congenital heart disease in 56,109 births. Incidence and natural history. Circulation. 1971 Mar;43(3):323–332. [PubMed]
  • Moller JH, Moodie DS, Blees M, Norton JB, Nouri S. Symptomatic heart disease in infants: comparison of three studies performed during 1969-1987. Pediatr Cardiol. 1995 Sep-Oct;16(5):216–222. [PubMed]
  • Wyllie JP, Madar RJ, Wright M, Burn J, Wren C. Strategies for antenatal detection of Down's syndrome. Arch Dis Child Fetal Neonatal Ed. 1997 Jan;76(1):F26–F30. [PMC free article] [PubMed]
  • Ferencz C, Rubin JD, McCarter RJ, Brenner JI, Neill CA, Perry LW, Hepner SI, Downing JW. Congenital heart disease: prevalence at livebirth. The Baltimore-Washington Infant Study. Am J Epidemiol. 1985 Jan;121(1):31–36. [PubMed]
  • Grabitz RG, Joffres MR, Collins-Nakai RL. Congenital heart disease: incidence in the first year of life. The Alberta Heritage Pediatric Cardiology Program. Am J Epidemiol. 1988 Aug;128(2):381–388. [PubMed]
  • Kidd SA, Lancaster PA, McCredie RM. The incidence of congenital heart defects in the first year of life. J Paediatr Child Health. 1993 Oct;29(5):344–349. [PubMed]
  • Ainsworth S, Wyllie JP, Wren C. Prevalence and clinical significance of cardiac murmurs in neonates. Arch Dis Child Fetal Neonatal Ed. 1999 Jan;80(1):F43–F45. [PMC free article] [PubMed]
  • Hiraishi S, Agata Y, Nowatari M, Oguchi K, Misawa H, Hirota H, Fujino N, Horiguchi Y, Yashiro K, Nakae S. Incidence and natural course of trabecular ventricular septal defect: two-dimensional echocardiography and color Doppler flow imaging study. J Pediatr. 1992 Mar;120(3):409–415. [PubMed]
  • Roguin N, Du ZD, Barak M, Nasser N, Hershkowitz S, Milgram E. High prevalence of muscular ventricular septal defect in neonates. J Am Coll Cardiol. 1995 Nov 15;26(6):1545–1548. [PubMed]
  • Abu-Harb M, Wyllie J, Hey E, Richmond S, Wren C. Presentation of obstructive left heart malformations in infancy. Arch Dis Child Fetal Neonatal Ed. 1994 Nov;71(3):F179–F183. [PMC free article] [PubMed]
  • Gregory J, Emslie A, Wyllie J, Wren C. Examination for cardiac malformations at six weeks of age. Arch Dis Child Fetal Neonatal Ed. 1999 Jan;80(1):F46–F48. [PMC free article] [PubMed]

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