RESUMO
OBJECTIVE: To determine the significance of cardiac symptoms in patients referred to paediatric cardiology outpatient clinics. MATERIAL AND METHODS: All patients above l month of age referred to paediatric cardiac outpatient clinics between 01-Apr-2004 and 31-Dec-2004. Data was collected prospectively in Internet data base. Patients were divided into 3 groups: patients referred by paediatricians to regional paediatric cardiology outpatient clinic (group 1, N=3383), patients referred to Academic Paediatric Cardiac outpatient clinics by paediatricians (group 2, N= 7461) and by cardiologists (group 2a, N=793). RESULTS: Average age of patients was 6.4 +/- 5.8 years. The most common reasons for referral included cardiac murmur, chest pain, syncope, earlier diagnosed congenital heart disease (CHD). The proportion of patients referred by cardiologists and paediatricians because of murmur was 30% vs 56%, arrhythmia 12.6% vs 8% and CHD 44% vs 8%. The percentage of the significant cardiac pathology in all groups (l/ 2/ 2a) was 38/35/76; in patients with chest pain -- 9/18/0; with syncope -- 56/70/80; with murmur -- 19/21/43; with CHD -- 68/69/93 and with arrhythmia -- 57/80/92. CONCLUSIONS: l. There were no significant differences between patients referred by paediatricians from regional and academic outpatient cardiology clinics. 2. Isolated cardiac symptoms such as chest pain, cardiac murmur and syncope were caused by significant cardiac pathology only in about 1/5 cases. 3. Cardiac murmur was the most common reason for referral to cardiac outpatient clinic in younger patients, in older group syncope and arrhythmia were more frequent.
