Incidence of previously unknown cardiac malformations in asymptomatic children after prenatal obstetric ultrasound screening.

BACKGROUND

Cardiac murmurs may be frequently found in otherwise asymptomatic children. Obstetric ultrasound screening for congenital heart disease is increasingly used to provide an antenatal diagnosis and an early treatment; thus, the incidence of cardiac anomalies in children has changed. We evaluated cardiac murmurs in otherwise healthy children referred to a level I pediatric cardiology institution.

METHODS

Echocardiography data from a cohort of 2045 patients from 2000 to 2009 were evaluated and the incidence and type of a newly diagnosed congenital heart disease have been determined.

RESULTS

The majority of the children with a cardiac murmur were found to have an innocent murmur, chordae tendinae, or a minor lesion. Children born after obstetric screening are nevertheless associated with a small risk of severe congenital heart disease. We found 14.9% with a previously unknown congenital cardiac malformation; 1.4% required medical treatment and 0.6% of the patients had either a catheter or a surgical intervention.

CONCLUSIONS

This study provides evidence that the use of obstetric screening for congenital heart disease reduces the occurrence of severe heart disease. Otherwise healthy children with murmurs still bear a small risk of having a cardiac defect, even if a prenatal study was negative. Therefore, the evaluation of children with a murmur by a pediatric cardiologist is recommended in an antenatally-screened population.