Value of Auscultation in Heart Murmurs During Childhood

It is known that clinical diagnosis of inconcent murmurs which are common in childhood is a problem for pediatricians. In this study a total of 75 patients (39 boys and 36 girls,) mostly refferred by a pediatrician suspecting a cardiac pathology, were evaluated. The patients were classified as having a "pathologic murmur" or an "innoccent murmur" after being examined by a pediatric cardiologist. Electrocardiography, telecardiography and echocardiography were performed in all patients. After our final evaluation in 50 patients with a clinical diagnosis of innocent murmur, echocardiographic evaluation changed the diagnosis to a pathologic murmur in 2 (4 %) patients. The clinical diagnosis of pathologic murmur in 25 patients changed in 2 (8 %) to an innocent one after echocardiographic studies. The sensitivity of the physical examination by a pediatric cardiologist was 92%, the specificity 96 %. The positive predictive value was 92% and the negative predictive value was 96%. Electrocardiography was normal in all patients. It was concluded that echocardiography is diagnostic in children with suspected heart disease but is unneccessary in pediatric patients with clinically diagnosed innocent heart murmurs. It would be time and money saving to perform echocardiography only in selected cases after a physical examination by a pediatric cardiologist.