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| The first 150 words of the full text of this article appear below. |
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Introduction |
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Although considerable effort has been invested in the
development of screening programmes to detect congenital heart disease before and after birth, a large proportion of infants with congenital heart defects remain undetected by these programmes and come to the
attention of the medical profession only after they develop symptoms.1 These symptomatic infants can present in
extremis and die rapidly. A study of 1590 babies with congenital heart disease who presented in the northern region of the United Kingdom was
published in this journal in 1999: one in 10 presented with cardiac
symptoms before the first neonatal screening examination and more than
half were considered to have a normal cardiovascular system at this
examination.1 Of these, almost 40% presented with
symptoms or died before the routine 6 week check. These observations are consistent with data from abroad, including the large
Baltimore-Washington Study, in which it was observed that, of all
infants with cardiovascular malformations
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