Cardiologic evaluation of children with suspected heart disease: experience of a public outpatient clinic in Brazil

Amaral, Fernando; Granzotti, João Antonio

doi:10.1590/s1516-31801999000300002

Cited by 11 publications

(6 citation statements)

References 20 publications

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“…We would like to conclude that an appropriate clinical cardiovascular evaluation might be an excellent instrument in the evaluation of children with a suspicion of cardiopathy 16 . Data here presented demonstrate, as already discussed 17 , that congenital cardiopathy tends to be excessively diagnosed, leading to the need for a careful evaluation before the diagnosis of a certain cardiopathy is reached. Immediate outhospital discharge of children with innocent murmurs seems to be an acceptable practice.…”

Section: Discussionsupporting

confidence: 61%

Initial diagnostic errors in children suspected of having heart disease: prevalence and long-term consequences

Amaral

Granzotti

2003

Arq. Bras. Cardiol.

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A global analysis demonstrated that diagnostic error in the initial evaluation of children with cardiac murmurs is real, reaching approximately 6% 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 suitable approach.

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Section: Discussionsupporting

confidence: 61%

Initial diagnostic errors in children suspected of having heart disease: prevalence and long-term consequences

Amaral

Granzotti

2003

Arq. Bras. Cardiol.

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“…About 85% of children have a multifactorial etiology of CHD, which is usually the only malformation in a child, and is result of interaction of many, in individual effect, still undefined genes and a number of other causes ( 5 , 6 , 7 ). Progress in understanding of etiology and pathogenesis of these conditions, that occurred lately, helps in the diagnosis and monitoring of these patients, as well as in the genetic counseling of the family in which we have CHD.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Congenital Heart Defects Treatment Options-Establishment of Pediatric Cardiology/Cardiosurgery in Bosnia and Herzegovina

et al. 2017

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Introduction:Modern pediatric cardiology mainly deals with congenital heart defects (CHD), as the most common congenital anomalies. In most cases CHD requires surgical or interventional treatment.Goal:The goal of the research was to evaluate CHD treatment at Pediatric Clinic, University Clinical Center (UCC) Sarajevo, Bosnia and Herzegovina (B&H). UCC Sarajevo is the only institution in B&H where cardiac treatment of CHD in pediatric population is performed. Pediatric cardiosurgery has started to develop in Bosnia and Herzegovina in April 1997.Patients and methods:Study included 745 patients (period from April 1997 to January 2017).Results:Cardiac treatment was performed on 745 patients with CHD, 541 (72.6%) of them were acyanotic patients and 204 (27.4%) were cyanotic patients. Reoperation was performed in 49 (6.5%) of patients. Out of total number of patients, 59 (7.9%) died. In 660 children (88.5%) a complete correction and in 85 (11.5%) a palliative operation/correction was performed. Defects with left to right shunt were present in 397 (53.2%) patients, complex heart defects with Tetralogy of Fallot in 173 (23.2%), obstructive heart defects in 106 (14.2%), obstructive heart defects with shunt in 53 (7.1%), and others in 16 (2.1%) of patients. During surgery, extracorporeal circulation was regulated in 554 (74.3%) patients. Peri and early postoperative complications occurred in 180 (24.1%) of patients. During this period 24 pacemakers were implanted and 24 radiofrequency ablations were performed.Conclusion:Results of CHD cardiac treatment in childhood, which took place simultaneously, followed by the contractual joint programs and individual work of the Bosnian and Herzegovinian team has reached the highest level in the last two years, not only by the number, type and complexity of corrected CHD, but also by the age and body weight of the patients who underwent surgery, and development of invasive procedures, arrhytmology, pacemaker placement, intensive peri and postoperative treatment. That led pediatric cardiac surgery of UCC Sarajevo, to a position of leading center in the region.

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“…The most common congenital anomalies are CHD (30%). The most common clinical sign in pediatric cardiology is a heart murmur, which can often be uncharacteristic ( 2 ). Heart murmurs are common in healthy infants, children, and adolescents ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Diagnostic Methods in the Differentiation of Heart Murmurs in Children

et al. 2016

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Introduction:The most common clinical sign in pediatric cardiology is a heart murmur (organic and inorganic). Organic are sign of heart disease, while inorganic (basically divided into accidental and functional) murmurs occur on anatomically healthy heart.Aim:To determine the justification of the application of the methods of cardiac treatment.Patients and methods:Study included 116 children aged from 1 to 15 years, who were referred due to cardiac treatment to Pediatric Clinic, of Sarajevo University Clinical Center.Results:The first group consisted of children with innocent heart murmur, 97 (53 males). The second group consisted of patients with organic murmur, 19 (13 males). The average age of the first group was 7.69 (1.01–15.01) years old, and of the second group 3.15 (1.01- 8.06) years old, and there is a significant difference between these two groups (p <0.001). Medical history questions about potentially harmful habits of mother in pregnancy, found significant differences in the frequency of the existence of habits between the first and second groups of subjects (14.44% vs. 85.1%, p = 0.013). The values of the pulse of patients showed statistically significant difference (p = 0.012). The most common place of the murmurs’ appearance is the second left intercostal space. In the first group, the most common were vibratory (32.3%) and ejection (31.9%) and in the second the most common were holosystolic (73.7%) murmur. Analyzing the R/S ratio of V1, a significant difference among the two groups was found (mean 0.78 vs. the values for 1.45, p = 0.003). There is a significance in terms of developed hypertrophy of the heart cavities (BVH) between the two groups. The most common accidental murmur was classic vibratory Still’s murmurs (55.43%) and the most common congenital heart defects was ASD (36.8%).Conclusions:A heart murmur itself, should not be the purpose of auscultation. One of the tasks of pediatricians, pediatric cardiologists in particular would be to improve auscultation, as a sovereign method of heart murmurs assessment. Heart murmur assessment should be adapted to recognize whether heart murmur is innocent, or there is suspected or probable congenital heart defect.

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Cardiologic evaluation of children with suspected heart disease: experience of a public outpatient clinic in Brazil

Cited by 11 publications

References 20 publications

Initial diagnostic errors in children suspected of having heart disease: prevalence and long-term consequences

Initial diagnostic errors in children suspected of having heart disease: prevalence and long-term consequences

Evaluation of Congenital Heart Defects Treatment Options-Establishment of Pediatric Cardiology/Cardiosurgery in Bosnia and Herzegovina

Evaluation of Diagnostic Methods in the Differentiation of Heart Murmurs in Children

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