Prevalence and clinical significance of heart murmurs detected in routine neonatal examination

ABSTRACT

To determine the prevalence and clinical impact of murmurs detected during routine physical examination in neonates. In a 4 years retrospective study, 6333 healthy newborn babies were screened for the presence of a heart murmur during routine neonatal physical examination. Prematures or those who were admitted to neonatal intensive care unit or any neonate with a risk factor that is known to be associated with increased incidence of congenital heart disease were excluded from the study. All those with murmurs underwent echocardiography examination and color Doppler study. Murmurs were detected in 87 neonate [1.37%] of whom 37 [42.5%] had a structural cardiac malformation. Ventricular septal defect [62%] was the most common diagnosis, followed by atrial septal defect, pulmonary stenosis and patent ductus arteriosus. The prevalence of heart murmur was 13.7 per 1000 neonate. If a murmur is heard there is a [42.5%] chance of their being underlying structural defects. Therefore, detection of a murmur should prompt early referral for investigation and diagnosis or appropriate family reassurance