Neonates
- Hospital discharge increasingly early – more detection by GPs
- Babies with murmurs should ie referred for early paediatric cardiological assessment
- Little point in review and delaying referral
- risky
- delays definitive diagnosis
- pulmonary vascular disease
- parental anxiety
Children
Benign murmurs are common; more marked when the child is pyrexial with an intercurrent illness. In this instance review in a couple of weeks is justified.
- Benign murmur
- high pitched or musical
- localised to lower left sternal border
- vary with position and respiration
- Venous hum
- high pitched continuous murmur below the clavicle or in the neck
- disappears on lying flat
Explain what a murmur is when you refer (‘an extra sound when you listen to the heart’). Many people interpret ‘murmur’ as a definite heart problem or as a physical entity inside the head.
Blood pressure
A controversial part of childhood screening, it may be the only sign of serious underlying renal disease
HOCM screening
- Much recent publicity
- it is very rare
- no proven treatment for reducing the risk of sudden death
- avoiding exercise does not remove the risk of sudden death
- the negative aspects of detection should be explained (as in HIV test counselling)