caa a22 4500 445824948 CHVBK 20180317145256.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s00246-011-9905-z doi (NATIONALLICENCE)springer-10.1007/s00246-011-9905-z Accuracy of Cardiac Auscultation in Asymptomatic Neonates with Heart Murmurs: Comparison Between Pediatric Trainees and Neonatologists [Elektronische Daten] [Karatza Ageliki, Fouzas Sotirios, Tzifas Sotirios, Mermiga Alexandra, Dimitriou Gabriel, Mantagos Stefanos] The aim of this study was to assess whether cardiac auscultation performed by pediatric trainees and neonatologists can reliably distinguish innocent from pathologic heart murmurs in asymptomatic neonates. From January 2008 to April 2009 the pediatric trainees of our institution were requested to refer all asymptomatic neonates with a murmur and classify the murmurs as "innocent,” "pathologic,” or "possibly pathologic.” Prior to echocardiography, each neonate was evaluated by two experienced neonatologists. The echocardiographic studies of 169 neonates were analyzed. Abnormal cardiac anatomy was found in 55 neonates (32.6%). The overall ability of pediatric trainees in identifying congenital heart disease (CHD) was moderate [area under the curve (AUC)=0.855] and significantly lower compared to neonatologists (AUC=0.919, p=0.007). However, at "lower” levels of clinical confidence (i.e., clinical diagnosis of possibly pathologic murmurs), pediatric trainees had good ability in excluding CHD (sensitivity 94.6%; negative likelihood ratio=0.09). The ability of cardiac auscultation for diagnosing CHD in asymptomatic neonates is limited and dependent on the physician's experience and level of clinical confidence. Echocardiography should remain an option for all neonates with a possibly pathologic murmur. Springer Science+Business Media, LLC, 2011 Congenital heart disease nationallicence Heart murmur nationallicence Neonate nationallicence Cardiac auscultation nationallicence Ageliki Karatza Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Patras, Patras, Greece aut Sotirios Fouzas Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Patras, Patras, Greece aut Sotirios Tzifas Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Patras, Patras, Greece aut Alexandra Mermiga Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Patras, Patras, Greece aut Gabriel Dimitriou Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Patras, Patras, Greece aut Stefanos Mantagos Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Patras, Patras, Greece aut Pediatric Cardiology Springer-Verlag 32/4(2011-04-01), 473-477 0172-0643 32:4<473 2011 32 246 https://doi.org/10.1007/s00246-011-9905-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00246-011-9905-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ageliki Karatza Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Patras, Patras, Greece aut NATIONALLICENCE 700 1- Sotirios Fouzas Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Patras, Patras, Greece aut NATIONALLICENCE 700 1- Sotirios Tzifas Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Patras, Patras, Greece aut NATIONALLICENCE 700 1- Alexandra Mermiga Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Patras, Patras, Greece aut NATIONALLICENCE 700 1- Gabriel Dimitriou Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Patras, Patras, Greece aut NATIONALLICENCE 700 1- Stefanos Mantagos Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital of Patras, Patras, Greece aut NATIONALLICENCE 773 0- Pediatric Cardiology Springer-Verlag 32/4(2011-04-01), 473-477 0172-0643 32:4<473 2011 32 246 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer