Prevalence and clinical significance of cardiac murmurs in schoolchildren

Kang, GuanYang; Xiao, Jing; Wang, Yitong; Wang, Jieying; Chen, Yuqiang; Liu, Qingchun; Chen, Qiaozhu; Yang, Fan; Li, Wei; Chen, Jiuhao

doi:10.1136/archdischild-2014-307819

Cited by 13 publications

(8 citation statements)

References 26 publications

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“…Burden estimates varied subnationally, by population subgroup, data source and over time. For example, in Dongguan City, 5 of 81 213 children aged 5–13 years screened in 2011–2012 had echo-confirmed RHD, 21 equating to 0.06 per 1000. Among adults aged 18–74 years from nine communities in urban and suburban China, prevalence of echo-detected RHD was 1.86 per 1000 in 2001–2002.…”

Section: Resultsmentioning

confidence: 99%

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Rheumatic heart disease across the Western Pacific: not just a Pacific Island problem

et al. 2017

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Some of the highest recorded rheumatic heart disease (RHD) prevalence and mortality rates are from the World Health Organization’s Western Pacific Region (WPR). RHD burden has been well documented in much of the WPR subregion of Oceania, but less is known about RHD outside the Pacific Islands and Australasia. We aimed to review RHD burden in WPR outside Oceania to identify countries with high RHD burden and those with contemporary data gaps. We searched the peer-reviewed literature for English-language primary studies published between 1980 and April 2017 that reported RHD prevalence or mortality in the 13 WPR countries/areas outside Oceania, and Taiwan. We also searched for official government reports and health indicator documents. Results were synthesised narratively and reported stratified by 2015 Human Development Index (HDI) level. 30 peer-reviewed publications fulfilling inclusion criteria were identified, representing nine countries/areas. RHD prevalence and mortality have fallen in association with economic development, particularly in very high HDI countries. In several countries that have undergone recent economic development, RHD persists particularly among older populations. In poorer WPR countries there is a persistent RHD burden, including in young populations. Some countries had no available data. Although RHD burden has declined in many high-resource settings across the WPR, in several poorer countries, the impact of RHD appears to continue. Elsewhere, insufficient contemporary data make it difficult to gauge the current status of RHD burden and control. Concerted efforts are needed to fill information gaps and implement action to address this avoidable disease.

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Section: Resultsmentioning

confidence: 99%

“…In China, studies since 2000 indicate persistent burden among school children aged 5–13 years 21 and the general population aged 30 and over 29 and 18–74 years. 20 Available Chinese data were predominantly from large cities; many less developed provinces had data gaps.…”

Section: Discussionmentioning

confidence: 99%

Rheumatic heart disease across the Western Pacific: not just a Pacific Island problem

et al. 2017

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“…However, our previous study showed that schoolchildren with the loudness of grades 3-6 and those younger than 10 years of age should raise a high index of suspicion of CHD and should refer to the echocardiographic examinations. 7 Therefore, the loudness grades of cardiac murmurs should be considered in this study. Data should be collected in the baseline clinical characteristics.…”

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confidence: 99%

“…We are surprised that this potentially important clinical characteristic has not been considered, despite the known increase in CHD risk with louder cardiac murmurs and younger age. 7 If the loudness grades of cardiac murmurs have been recorded in the study presented by Dilek Dilli and colleagues, it would have been of utmost interest to consider this factor in this study to evaluate its potential contribution to the CHD risk.…”

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confidence: 99%

Significance of cardiac murmurs in detection of congenital heart disease

Kang

Zhang

2019

Cardiol Young

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“…Congenital heart disease may be diagnosed prenatally, during birth or during hospitalization; however, many cases are asymptomatic for the first days and may go undetected. It is important to remember that most murmurs are not pathological, but a murmur may be the first or only clue to consequential congenital heart disease [2,3].…”

Section: Introductionmentioning

confidence: 99%

Cardiac Murmurs Auscultated in Infancy and Their Importance to Medical Students

Kerna¹

2017

JPNC

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The cardiac system is a substantial section on medical board examinations. Different levels of providers are expected to have a certain degree of knowledge of the cardiac system within their scope of practice. This article reviews basic infant heart murmurs, diastole vs. systolic classification, and history taking with physical examination components to obtain a differential diagnosis at the level of a third or fourth year medical student. Although benign heart murmurs are common in the pediatric population, it is critical to obtain a detailed history and be able perform a thorough physical examination in the infancy population during the critical postpartum period as some heart murmurs are life-threatening. The medical student should attempt to differentiate between the nature of the murmur-either benign or pathological-and resolve it in a reasonable time frame to ensure the health of the infant. Many pediatricians will automatically refer to a pediatric cardiologist for a specialist assessment; however, this can lead to an overflow of patients for the pediatric cardiologist, and influence patient turnaround and the ability to accept new patients.This article outlines basic fetal circulation. It describes a focused cardiac physical examination for the scope of medical students in either third or fourth year (clinical rotations), and helps differentiate the heart murmur classifications. The information provided is a good starting point for neonatal/pediatric rotations and will prepare medical students for their end of rotation examination. It can also assist in pediatric cardiology elective rotation. The ability to classify each heart murmur based on physical exam findings is sometimes difficult for medical students transitioning to clinical rotations. The goal herein is to provide adequate and up-to-date information for the level of the audience. anticonvulsants or antidepressants [5]. Finally, the medical student should inquire about family history to include congenital heart defects or genetic malformations [6]. Keywords: Focused Cardiology Physical ExaminationHeart sounds should be described by their intensity, location and radiation, quality, and timing in the cardiac cycle [3].Intensity: Heart sounds can be described as low-pitched or high-pitched sounds. High-pitched sounds are often heard best with the diaphragm of the stethoscope [3].Location and Radiation: The location of the heart sound can help determine the etiology of the murmur [3]. The standard listening areas on the chest (aortic, pulmonic, tricuspid and mitral) apply to both heart sounds and murmurs [3]. It is also important to assess where the murmur radiates to within the heart. Quality: Quality of the murmur is often described as mechanical, harsh, soft, vibratory or blowing in nature [3].Timing: The timing of the heart sounds is described in relation to the cardiac cycle: early, mid, or late systole; or early, mid or late diastole [3].The First Heart Sound (S1): The first heart sounds (S1) represents closure of the atrioventricular ...

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Prevalence and clinical significance of cardiac murmurs in schoolchildren

Abstract: The study suggested that apparently healthy schoolchildren with grade ≤2 cardiac murmurs are least likely to have underlying SHD, especially in those aged ≥10 years. However, echocardiography should be performed in younger schoolchildren with cardiac murmur grade ≥3.

Cited by 13 publications

References 26 publications

Rheumatic heart disease across the Western Pacific: not just a Pacific Island problem

Rheumatic heart disease across the Western Pacific: not just a Pacific Island problem

Significance of cardiac murmurs in detection of congenital heart disease

Cardiac Murmurs Auscultated in Infancy and Their Importance to Medical Students

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