How Innocent Are Innocent Murmurs?
Abhishek Kumar Sharma
Innocent murmurs occur in allmost 50 % of all children.Therefor doctors often encounter children with heart murmurs.The dilemma faced at such a time is wheather 535j95f to send for furthur evaluations like ECG, chest x ray and echocardiography or reassure the parents without furthur evaluation.
Aims Of Study
1. to assess the sensitivity of pediatricians in a clinical detection of inncocent murmurs
2. to determine usefulness of ECG, x ray and echocardiography in clinically diagnosed innocent murmurs.
Materials and Methods
This study was conducted at civil hospital Palampur.Children aged 1 month to 18 years, clinically diagnosed as innocent murmurs from one of the 2 pediatricians in study, were included. Pediatricians were given a chance to review the diagnosis, after interpretation of ECG and chest x rays. Echocardiography was done in all of teh patients.
Results
Out of total of 30 children in whom mean age was 6.7 years. M:F ratio was 2.2:1.
Still murmur was heared 16.4 % of patients. All MURMURS WERE GRADE 1/6 TO 2/6 in intensity.Murmurs were better heared in supine positiona nd after exercise. Chest x rays were normal in all cases. ECG was abnormal in 2 cases, but subsequently echocardiogrphy was normal in these 2 cases. Of the 30 cases, 2 cases had cardiac lesions. Two had mitral valve prolapse without mitral regurgitation and one case had uniform left ventricular hypertrophy. All the 3 lesions were hemodynamically insignificant. Therefore, the sensitivity of pediatricians in cliniaclly diagnosing innocent murmurs was 90 %.
Conclusion
We conclude that pediatricians has good sensitivity in clinically diagnosing innocent murmurs. Routine diagnositic tests like ECG, chest x ray, and echocardiography are rarely helpful in clinically diagnosed innocent murmurs. Hence, they are unnecessary if the murmur is clinically diagnosed innocent.
|
