Examination for cardiac malformations at six weeks of age

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Abstract
AIM To attempt to define the prevalence and significance of murmurs detected on routine clinical examination at six to eight weeks. METHODS A retrospective review of the results of routine clinical examination of a cohort of 6 to 8 week old babies resident in Newcastle upon Tyne, was carried out in two 12 month periods. All cardiac defects diagnosed in infancy in the same cohort were ascertained. RESULTS 7132 babies were eligible for routine examination; 83% of these were examined. Murmurs were heard in 47 of 5395 babies and in 11 of 25 referred for evaluation congenital heart disease was found. The six to eight week examination led to diagnosis of 11 of 35 cases (31%) of congenital heart disease in the study population. CONCLUSIONS Nearly one baby in 100 had a murmur on routine examination at six to eight weeks. Nearly half of those with murmurs who were referred had a structural cardiovascular malformation. Only 83% of eligible babies received routine examination for signs of heart disease and only 56% between 6 and 8 weeks of age. Murmurs were heard in roughly one baby in 100 (0.9%). About one quarter of babies with murmurs had structural heart disease but only about half were referred. Referral of all babies with murmurs at this age for expert evaluation is recommended.