Comparison of initial evaluation of neonatal heart murmurs by pediatrician and pediatric cardiologist

Abstract

The objective of this study was to determine differences between pediatrician and pediatric cardiologists regarding initial assessment of neonatal heart murmur and to evaluate the role of echocardiography in this group of patients. During a 6-month period, all term births in the obstetric unit at Faculty of Medicine, Gazi University, Ankara, Turkey, were initially evaluated clinically by a pediatrician and the most likely clinical diagnosis was recorded. Neonates with a heart murmur were evaluated by the pediatric cardiologist who was unaware of the previous diagnosis. A similar number of neonates without a heart murmurs was also evaluated by a pediatric cardiologist as a control group. Echocardiography was performed in both groups. For pediatrician and pediatric cardiologists, accuracy of the clinical examination demonstrated a sensitivity of 33.3% and 40% in detecting a pathological murmur and a specificity of 95.5% and 98.8%, respectively. No statistically significant differences existed between the two groups. Pediatricians can assess the significance of neonatal heart murmurs as well as pediatric cardiologists.