[Significance of Doppler echocardiography in the diagnosis and management of children with heart disease].
OBJECTIVE
To assess the accuracy of Doppler-echocardiography in the diagnosis and management of the child with heart disease.


METHODS
Prospective echocardiographic study of 132 consecutive patients aged 1 day to 16 years old with heart disease confirmed by cardiac catheterization (n = 109) or anatomic examination (surgical = 21, necropsy = 2).


RESULTS
Of the 258 cardiovascular anomalies diagnosed by cardiac catheterization and anatomical examination, 247 were correctly identified by echocardiography (sensitivity = 96%). There were 11 missed and 4 false positive diagnosis (specificity = 98%), all of them were vascular anomalies. Intracardiac anatomy and segmentary alignment were always correctly identified. The 21 cardiovascular anomalies operated without cardiac catheterization were correctly diagnosed. In 16 patients (12%) a management plan could not be established only on clinical echocardiographic grounds and, in another patient, the plan was incomplete. In the remaining 115 patients (87%) the management plan was correct and complete.


CONCLUSIONS
The clinical-echocardiographic study allows: 1) an excellent anatomo-functional evaluation of the heart and great vessels, 2) surgical repair of some selected cardiovascular anomalies without previous cardiac catheterization.
Nascimento
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R
Unidade de Cardiologia Pediátrica, Hospital de S. João, Porto.
Bastos
P T
PT
Van Zeller
P
P
Cunha
D
D
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003951:Diagnostic Errors; D015150:Echocardiography, Doppler; D005189:False Positive Reactions; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies
Valor da ecocardiografia-Döppler no diagnóstico e orientação da criança com doença cardíaca.