A comparison of clinical paediatric murmur assessment with echocardiography

Sub-title
AuthorsAmaris Spiteri MD, MRCPCH
J Torpiano MD, MRCP(UK)
Mark Bailey MD, MRCP(UK)
Victor Mercieca MD, Spec. Paed. (Leuven)
V Grech PhD MRCP(UK)
AbstractObjective: To compare the clinical acumen of paediatric cardiovascular examination between various hospital paediatrician grades. Design: Prospective data collection of clinical and echocardiography findings on paediatric echocardiography referrals. Setting and patients: All paediatric patients (birth - 14 years) referred for echocardiography, in a regional hospital catering for the island population of Malta. Echocardiography was carried out by three paediatricians with tertiary training in this technique. Main outcome measures: Pre-echocardiography clinical diagnoses were compared with echocardiography results according to grade of referring hospital doctor (ranging from houseman to consultant). Both normal and abnormal hearts at echocardiography were included. Results: Echocardiographers had the highest clinical accuracy and the highest attempts at reaching a clinical diagnosis. Accuracy and attempts at diagnosis decreased as doctor's hospital grade decreased, from consultant to houseman. Ventricular septal defect was the most easily diagnosed lesion. Atrial septal defect was often misdiagnosed as pulmonary stenosis.

Published in:
JournalMalta Medical Journal
Volume16 Issue 04
Pages29 - 33
Date01/11/2004
Link to journal

Key wordsclinical acumen, diagnostic accuracy, echocardiography, murmur, paediatrics

Compiled by: Dr. I. Stabile    Dr. J. Pace