PERSPECTIVE
Congenital heart disease
How effectively can clinical examination pick up congenital heart disease at birth?
Correspondence to:
Correspondence to:
Dr Onuzo
University Hospital of Wales, Paediatric Cardiology, Heath Park, Cardiff CF14 4XW, Wales, UK; obed.onuzo@cardiffandvale.wales.nhs.uk
Perspective on the paper by Patton and Hey (see page 263)
Keywords: cardiac murmur; congenital heart disease; examination; screening
| The first 150 words of the full text of this article appear below. |
Congenital heart disease (CHD) is a major cause of death in infancy in term babies. It accounts for 3% of all infant deaths and 46% of all deaths from congenital malformations.1 Those surviving beyond infancy have a 96% chance of reaching 16 years.2 It is for these reasons that screening for CHD is essential. Routine antenatal screening for congenital heart defects is performed as part of the general anomaly scan at 18–20 weeks gestation. At present, this identifies on average about 25% of affected fetuses. Because of this low yield, routine clinical examination of all newborn babies remains necessary with the expectation that those with heart defects will be picked up.
The vast majority of these early deaths, particularly those occurring in the first two weeks of life, are due to a handful of lesions. They are the so called duct dependent lesions, namely coarctation of the
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