Accuracy of cardiac auscultation in detection of neonatal congenital heart disease by general paediatricians.

Abstract:

BACKGROUND:Challenges remain in the judgement of pathological murmurs in newborns at maternity hospitals, and there are still many simple major CHD patients in developing countries who are not diagnosed in a timely fashion. This study aimed to evaluate the accuracy of cardiac auscultation on neonatal CHD by general paediatricians. METHODS:We conducted a prospective study at three hospitals. All asymptomatic newborns underwent auscultation, pulse oximetry monitoring, and echocardiography. Major CHD was classified and confirmed through follow-up. We evaluated the accuracy of various degrees of murmurs for detecting major CHD to determine the most appropriate standards and time of auscultation. RESULTS:A total of 6750 newborns were included. The median age of auscultation was 43 hours. Cardiac murmurs were identified in 6.6% of newborns. For all CHD, 44.4% had varying degrees of murmurs. A murmur of grade ≥2 used as a reference standard for major CHD had a sensitivity of 89.58%. The false positive rate of murmurs of grade ≥2 for detecting major CHD was significantly negatively related to auscultation time, with 84.4% of false positives requiring follow-up for non-major CHD cardiac issues. Auscultation after 27 hours of life could reduce the false positive rate of major CHD from 2.7 to 0.9%. CONCLUSIONS:With appropriate training, maternity hospital's paediatricians can detect major CHD with high detection rates with an acceptable false positive rate.

journal_name

Cardiol Young

journal_title

Cardiology in the young

authors

Zhao QM,Niu C,Liu F,Wu L,Ma XJ,Huang GY

doi

10.1017/S1047951119000799

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

679-683

issue

5

eissn

1047-9511

issn

1467-1107

pii

S1047951119000799

journal_volume

29

pub_type

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