Background Congenital heart disease affects 6–8 per 1000 live births. Heart murmurs are present in approximately 5–10% babies on postnatal examination. Studies suggest that with a murmur there is a 45–50% risk of an underlying cardiac malformation, increasing parental anxiety.

Objective To review our echocardiography service, focusing on the indications, findings and the subsequent outcomes of babies from the postnatal ward.

Methods Information from all echocardiograms performed on the neonatal unit was collected prospectively over 3 years. We retrospectively reviewed all echocardiograms from postnatal ward babies during this period. We evaluated the indications, median age, findings, management and outcome.

Results A total of echocardiograms 408 were performed on 350 babies on the postnatal ward. The most common indication was murmur (58%). The median age for performing the scan was 2 days. In 36% babies, the echocardiogram was normal. 2% of babies had major congenital heart disease, 22% minor structural heart defects, 40% had transient echocardiographic findings. 40% were discharged with no follow-up, 32% were followed up in the local cardiac clinic and 28% were referred to the paediatric cardiologist.

Conclusion Postnatal echocardiogram is valuable in early identification and appropriate referral of structural heart defects to the paediatric cardiologist. It has an equally important role in providing reassurance to families of babies with normal hearts prior to discharge from hospital. Where resources are available, postnatal echocardiography service has the potential to decrease follow-up clinic load for heart murmurs.