ABSTRACT
Innocent heart murmur is a frequent auscultatory finding in children. The diagnosis is essentially clinical, without need for further investigation. However, excluding heart disease can be a difficult task. This review article describes some features of medical history and physical examination that help in this differentiation. The role of diagnostic tests is also examined.
Subject(s)
Heart Murmurs , Child , Heart Murmurs/classification , Heart Murmurs/diagnosis , Heart Murmurs/etiology , Humans , Physical ExaminationSubject(s)
Aorta/abnormalities , Aortic Valve/abnormalities , Diseases in Twins , Abnormalities, Multiple/diagnostic imaging , Aorta/diagnostic imaging , Aortic Valve/diagnostic imaging , Diseases in Twins/diagnostic imaging , Fatal Outcome , Heart Defects, Congenital/diagnostic imaging , Humans , Infant, Newborn , Male , UltrasonographyABSTRACT
BACKGROUND: Telemedicine is an excellent tool to expand specialized medical care, providing better access for patients and lowering costs for their families. The objective of this work was to evaluate the reliability of teleconsultation in pediatric cardiology, with similar results to traditional consultation. It can be a useful tool to upgrade technical skills among the staff involved and to improve the quality of life of patients and families. METHODS: The authors present their 5 years' experience of pediatric cardiology teleconsultation involving Coimbra Central Pediatric Hospital and district hospitals in the central region of Portugal. During this period 1761 consultations, involving 1056 patients, were given with a pre-established weekly schedule for each hospital and joint online reports were produced, with data confidentiality assured. RESULTS: Cardiac murmur was the most common reason for consultation (73%). No heart disease was diagnosed in 49% of the patients. Among septal defects, accounting for 43%, ventricular septal defect was the most frequent (20%). Only 10% of all patients had to be seen in the Pediatric Hospital Cardiology Department. Six emergency consultations were requested. CONCLUSIONS: Pediatric cardiology teleconsultation is a reliable procedure using the Medigraf platform, with a similar error rate to consultations by traditional methods. The costs are lower, especially for the families, who do not have to travel far from home or take time off work. The waiting time for a consultation is shorter and therapeutic decisions are faster. A pediatric cardiologist can cover a larger geographic area and the cooperative work during sessions is useful for exchanging knowledge and experiences.
