Dr. Mujeeb Rahman M. K. T
BACKGROUND The prevalence of heart murmur during the first week of birth varies from 0.6-44.7% and congenital heart disease (CHD) varies from 4-50 per 1000 live births in different studies. Though most are clinically insignificant, few are associated with various structural abnormalities. Our study was conducted to determine the prevalence of cardiac murmurs and congenital heart disease in neonates of rural Kerala. METHODS 1000 consecutive live born neonates were enrolled in our descriptive study during a period of 10 months conducted at Sree Gokulam Medical College & Research Foundation Venjaramoodu. Neonates were screened after 24 hours of birth by residents using 3M® Littman™ paediatric stethoscope and all detected murmurs were referred to cardiologist for echocardiography. Study was conducted after approval from Institutional Ethics Committee and written informed consent was obtained from all participating mothers. Data was collected in semi structured questionnaire and are expressed as proportions. RESULTS 19 and 14 neonates had audible murmur and CHD with a prevalence of 19 and 14 per 1,000 live births respectively. 85.7% (n=12) of lesions were acyanotic lesions and 14.3% (n=2) were cyanotic. Congenital heart diseases encountered were atrial septal defect (26.3%), ventricular septal defect (26.3%), patent ductus arteriosus (5.3%), cyanotic heart with multiple lesions (10.5%), tetralogy of Fallot (5.3%) and hypoplastic left heart syndrome (5.3%). CONCLUSIONS Structural lesion was seen in 73.7 cardiac murmurs. Atrial septal defect and ventricular septal defects were the most common structural lesions.
