CONGENITAL HEART DISEASE IN CHILDREN WITH ACCIDENTALLY DISCOVERED MURMUR

Author Name: 1. Dr. Sarah Falih Nghaimesh 2. Dr. Rabab Hassan Baqer 3. Dr. Sawsan Ali Hussein

Volume/Issue: 02/11

Country: Iraq

DOI NO.: 08.2020-25662434 DOI Link: https://www.doi-ds.org/doilink/05.2022-41346977/UIJIR

Affiliation:

1. Central Child Teaching Hospital, Baghdad, Iraq
2. Pediatrics, Medical College, Mustansiriyah University, Baghdad, Iraq
3. Pediatrics, Medical College, Mustansiriyah University, Baghdad, Iraq

ABSTRACT

Murmur is an auditory vibration resulting from turbulent blood flow within the cardiovascular system. Once a murmur is detected, a complete and systematic clinical assessment to identify the aetiology of the murmur should be done. Patients with non-critical congenital heart diseases may be completely asymptomatic or have murmur as their sole clinical manifestation. To determine the frequency of congenital heart diseases in patients who had murmur discovered accidentally and to find out any possible predicting factor for early diagnosis. A case-control study was conducted on 40 patients with murmur discovered accidently during cardiac examination of the patients admitting the ER regardless their symptoms compared with another 40 patients (selected randomly) but had no murmur. The study was conducted at the Child's Central Teaching Hospital over a period of 5 months from the 1st of September, 2019 till the 7th of February, 2020. Neonates and patients known to have CHD were excluded from the study. It has been found that 32 (80%) patients who had murmurs discovered accidentally had congenital heart diseases and 8 patients (20%) had no congenital heart diseases (innocent murmur). Atrial septal defect was the commonest CHD discovered [ 13 out of the 32 patients (40.63%)], followed by Patent Foramen Ovale, Patent Ductus Arteriosus, Pulmonary valve Stenosis, and Mitral Regurgitation [15.6, 15.6, 6.3 and 3.1% respectively. the mean age of patients who had murmur was 6.7 months ± 12.21 months (SD), While the mean age of patients in whom no murmur was detected was a bit higher [11.8 months ± 26.88 (SD). The females with CHD were more than males, with male to female ratio of 1:1.3 vs. 1.66:1. But neither the difference in mean age nor gender difference was statistically significant. There was significant association between the family history of congenital heart diseases and the presence of congenital heart diseases, highest percentage of CHD was found in patients who had positive family history [7 out of 9 patients (77.8%) compared with 25 out of 63 (38%)] (P= 0.03144). Other clinical presentation, weight, mother age, medical illness, the residency had no significant correlation with the presence of CHD. Accidental discovery of murmur may indicate the presence of CHD especially in ages less than 6 months, females and presence of positive family history of CHD.

Key words: murmur, congenital heart disease.