Congenital heart diseases in the newborn: from the pediatrician's request to the cardiologist's evaluation.
OBJECTIVE
To analyze the importance of symptoms as a reason for referral to pediatric cardiologists in the diagnosis of congenital heart diseases (CHD) in the newborn (NB).


METHODS
Prospective study on live NB referred for cardiac evaluation, with performance of electrocardiogram, chest radiography and echocardiography. Cardiology consultation was requested by means of a multiple-choice form including signs and symptoms suggestive of CHD. Patent ductus arteriosus (PDA) without clinical and/or hemodynamic consequences was not considered a heart disease.


RESULTS
From 1999 to 2002, 358 out of 3716 NB were studied, and 49 cases of CHD and 128 of PDA were found. The prevalence of CHD was 13.2:1000 NB. The main reason for referral to the cardiologist was heart murmur in 256 (72%) NB, of which 39 (15%) had CHD, and in 91% of the 128 cases of PDA. In 14 (4%) NB, the reason for referral was cyanosis, and eight of these patients (57%) had a CHD. Heart failure was the reason for referral in 37 (10%) NB, of whom 17 (46%) had CHD. Arrhythmia, associated congenital malformations, or chromosome disorders were the reasons for referral in 14% of the cases.


CONCLUSIONS
The main reason for referral was detection of a heart murmur on cardiac auscultation. Although cyanosis and heart failure were uncommon reasons for referral, their presence indicated a high probability of the diagnosis of heart disease. Pediatric screening plays a key role in this diagnosis.
Rivera
Ivan Romero
IR
Universidade Federal de Alagoas, Maceió, AL, Brasil. irrivera@uol.com.br
Silva
Maria Alayde Mendonça da
MA
Fernandes
José Maria Gonçalves
JM
Thomaz
Ana Claire Pimenteira
AC
Soriano
Cláudio Fernando Rodrigues
CF
Souza
Maria Goretti Barbosa de
MG
D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D002309:Cardiology; D003490:Cyanosis / Q000175:diagnosis / Q000453:epidemiology; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis / Q000453:epidemiology; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000453:epidemiology; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology; D006334:Heart Function Tests; D006337:Heart Murmurs / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D010372:Pediatrics; D015995:Prevalence; D011446:Prospective Studies; D012017:Referral and Consultation