Erros diagnósticos na avaliação inicial de crianças com suspeita de cardiopatia: prevalência e possíveis consequências a longo prazo / Initial diagnostic errors in children suspected of having heart disease: prevalence and long-term consequences
Arq. bras. cardiol
;
81(2): 148-155, ago. 2003. tab
Artículo
en Portugués, Inglés
| LILACS
| ID: lil-345311
RESUMO
OBJECTIVE:
To access the incidence of diagnostic errors in the initial evaluation of children with cardiac murmurs.METHODS:
We evaluated our 7-years of experience in a public pediatric cardiology outpatient clinic. Of 3692 patients who were sent to the hospital, 2603 presented with a heart murmur and were investigated. Patients for whom a disagreement existed between the initial and final diagnoses were divided into the following 2 groups G1 (n=17) with an initial diagnosis of an innocent murmur and a final diagnosis of cardiopathy, and G2 (n=161) with an initial diagnosis of cardiopathy and a final diagnosis of a normal heart.RESULTS:
In G1, the great majority of patients had cardiac defects with mild hemodynamic repercussions, such as small ventricular septal defect and mild pulmonary stenosis. In G2, the great majority of structural defects were interventricular communication, atrial septal defect and pulmonary valve stenosis.CONCLUSION:
A global analysis demonstrated that diagnostic error in the initial evaluation of children with cardiac murmurs is real, reaching approximately 6 percent of cases. The majority of these misdiagnoses were in patients with an initial diagnosis of cardiopathy, which was not confirmed through later complementary examinations. Clinical cardiovascular examination is an excellent resource in the evaluation of children suspected of having cardiopathy. Immediate outpatient discharge of children with an initial diagnosis of an innocent heart murmur seems to be a suitableapproach:
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Soplos Cardíacos
/
Errores Diagnósticos
Tipo de estudio:
Estudio diagnóstico
/
Estudio de incidencia
/
Estudio de prevalencia
/
Estudio pronóstico
/
Factores de riesgo
/
Estudio de tamizaje
Límite:
Niño
/
Child, preschool
/
Femenino
/
Humanos
/
Lactante
/
Masculino
País/Región como asunto:
America del Sur
/
Brasil
Idioma:
Inglés
/
Portugués
Revista:
Arq. bras. cardiol
Asunto de la revista:
Cardiología
Año:
2003
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
Universidade de São Paulo/BR
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