Cardiologic evaluation of children with suspected heart disease: experience of a public outpatient clinic in Brazil

Sao Paulo Medical Journal

Fernando Amaral¹  João Antonio Granzotti¹ 

[1] ,Faculdade de Medicina de Ribeirão PretoRibeirão Preto,Brazil

关键词: Heart disease;    Child;    Incidence;    Epidemiology;   

DOI  :  10.1590/S1516-31801999000300002

来源: SciELO

【 摘 要 】

CONTEXT: 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. DESIGN: Retrospective analysis of all patients submitted to cardiologic evaluation within a 39 month period. SETTING: public pediatric cardiology outpatient clinic. PARTICIPANTS: 2675 consecutive children aged £15 years referred from the local and regional basic health units due to suspected heart disease. MAIN MEASUREMENTS: Reason for referral, diagnostic investigation, final diagnostis 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.

【 授权许可】

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