TY - CHAP M1 - Book, Section TI - The Neonate and Infant with Cardiovascular Disease A1 - Teitel, David F. A2 - Kline, Mark W. PY - 2018 T2 - Rudolph's Pediatrics, 23e AB - Cardiac defects are the most common congenital malformation, occurring in up to 1% of all live births (even excluding bicuspid aortic valve and very small atrial and muscular ventricular septal defects), and present symptomatically in about 20% of such neonates. It is thus essential that the clinician diagnose symptomatic cardiac disease expeditiously. Because of the concern for serious cardiac disease, many clinicians consider the presence of a murmur as the most definitive evidence of heart disease. A murmur, however, is not an accurate sign of symptomatic neonatal heart disease. Many normal neonates have murmurs at some time during the first few days of life, whereas several common symptomatic cardiac defects, such as total anomalous pulmonary venous connection and simple transposition of the great arteries, are not associated with murmurs. In the neonatal period, the presence of a murmur is neither sensitive nor specific to the diagnosis of heart disease, yet it is commonly used both to consider and, most concerning, to exclude the presence of a significant cardiac defect. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1182913534 ER -