ECHO-Doppler evaluation of systolic murmurs in infancy

ABSTRACT

Echo- Doppler with colour flow mapping technique was carried out on 15 full term neonate infants and on 55 infants aging from 1-24 months who presented with systolic murmurs over a period of 18 months. This was done to evaluate the clinical value of ECG and echodoppler in assessment of systolic murmurs in infancy. Among the 15 neonates only 3 cases [20%] were found free echocardiographically and the other 12 [80%] had different pathologic echocardiographic findings. On the other hand, in the 55 studied infants [ages from 1-24 months], echocardiographic study revealed no cardiac abnormalities in 31 cases [56%], while definite heart disease was present in 24 cases [44%]. The initial referral diagnosis of the systolic murmur [innocent vs pathologic] was correlated with the echocardiographic finding. On clinical examination, 65% of the murmurs were initially evaluated as inoccent and the other 35% pathologic. The clinical examination had a sensitivity of 70.8%, specificity of 90.3%, positive predictive value of 85% and negative predictive value of 80%. The diagnosis of all the cases was not changed after ECG studies. However, on echocardiographic studies, a higher incidence of pathologic cardiac lesions [44% of cases] was identified, Echocardiography with colour doppler was found necessary in early diagnosis and management of suspected congenital heart disease in infancy even in a clinically diagnosed innocent systolic heart murmur