title: Cardiologic evaluation of children with suspected heart disease: experience of a public outpatient clinic in Brazil.
abstract: BACKGROUND
  During initial evaluation of children on an outpatient basis, the index of suspected heart disease may be high, particularly if we consider that innocent murmur occurs in about 50% of the pediatric population. This is the most common cause of referral to the pediatric cardiologist.
  
  
  OBJECTIVE
  To report on the experience of a public outpatient clinic in the southeastern region of Brazil.
  
  
  METHODS
  Retrospective analysis of all patients submitted to cardiologic evaluation within a 39 month period.
  
  
  METHODS
  Public pediatric cardiology outpatient clinic.
  
  
  METHODS
  2675 consecutive children aged</=15 years referred from the local and regional basic health units due to suspected heart disease.
  
  
  METHODS
  Reason for referral, diagnostic investigation, final diagnosis based on the reason for referral, therapeutic procedures.
  
  
  RESULTS
  The main reasons for referral were: murmur (70%), precordial pain (9%), suspicion of arrhythmia (9%) and breathlessness (5%). Of the total number, 695 cases (26%) did not complete the investigation and were not included in the analysis. A final diagnosis was obtained based on the reason for referral and the main conclusions were: l) a high incidence of normality was found: murmur (83%), pain (98%), arrhythmia (97%) and breathless (94%); 2) heart disease was unlikely, based on other referral reasons; 3) 14% of the children were considered abnormal and 1% needed therapeutical procedures.
  
  
  CONCLUSIONS
  The establishment of a pediatric cardiology outpatient clinic within the public health service in the region seems to be justifiable, due to the high current demand. The low global incidence of heart disease, with a high prevalence of children with innocent murmur, discloses the need for a specific training program in cardiology for pediatricians.
authors.affiliation: Department of Pediatrics, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, Brazil.
authors.forename: F
authors.initials: F
authors.lastname: Amaral
authors.forename: J A
authors.initials: JA
authors.lastname: Granzotti
mesh_terms: D000554:Ambulatory Care Facilities; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis* / Q000453:epidemiology; D006337:Heart Murmurs / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies