RT Book, Section
A1 Teitel, David F.
A2 Kline, Mark W.
SR Print(0)
ID 1182913534
T1 The Neonate and Infant with Cardiovascular Disease
T2 Rudolph's Pediatrics, 23e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259588594
LK accesspediatrics.mhmedical.com/content.aspx?aid=1182913534
RD 2024/04/18
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.