The Results of Echocardiography Applied to Heart Murmurs in Two Different Centers: is Geography Destiny?

Year 2024, , 30 - 35, 07.05.2024

Merve Maze Aydemir , Bekir Yukcu , Veysel Tahiroğlu

https://doi.org/10.26650/jchild.2024.1399606

Abstract

Objective: Heart murmurs in childhood are the most common reason for pediatric cardiology consultations worldwide. The aim of this study is to investigate the frequency and etiology of congenital heart disease (CHD) in two different centers possessing significant differences in factors such as geography, climate, and sociocultural conditions.

Methods: The study involves patients who’d been referred to the pediatric cardiology outpatient clinic due to heart murmurs between November 2022-October 2023. All patients were evaluated by echocardiograph to investigate the causes of the murmur.

Results: The study includes 2,127 patients (1,452 from Şırnak and 675 from Giresun; median age = 1.95 years). The gender distributions were similar in both regions. Pathological heart murmurs were more prevalent in Şırnak (21.6%) compared to Giresun (7.7%), while Giresun had a higher percentage of innocent murmurs (92.3%). Cyanotic conditions were rare. Surgery was required for 3.7% of patients overall (4.5% in Şırnak; 1.9% in Giresun). Normal echocardiograms were found in 46% of the total population, with variations being 41% in Şırnak and 56% in Giresun. Pathological murmurs were more common in females. Patients with pathological murmurs were more likely to require surgery. Şırnak had more pathological echocardiography results and a higher need for surgery. Neonates were the age group most frequently requiring surgery in both centers.

Conclusions: Educating society and fostering awareness are imperative steps for preventing consanguineous marriages and encouraging appropriate birth intervals. Swift public education is particularly crucial in developing nations marked by elevated consanguinity rates and limited financial resources, highlighting the potential detrimental consequences of inbreeding.

Keywords

Child, echocardiography, cardiac murmur

Thanks

Verilerin toplanmasında yardımcı olan Mustafa Altun’a ve Hakan Ateş’e teşekkür ediyoruz.

References

• Patel SS, Burns TL.; Nongenetic risk factors and congenital heart defects. Pediatric Cardiology 2013;34:1535-55. https://doi. org/10.1007/s00246-013-0775-4. google scholar
• Salihoğlu M, Palanduz A, Yolar L, Arapoğlu M, Kiliç D, Kayaalp N.; Doğumsal Kalp Hastalığı Ön Tanısı ile İzlenen Yenidoğanların Değerlendirilmesi. Şişli Etfal Hastanesi Tıp Bülteni 1999;33:23-7. google scholar
• Karacan M, Olgun H, Orhan MF, Altay ND, Öztürk CF, Karakelleoğlu C, et al.; Undiagnosed cardiac abnormalities among school-aged children. Guncel Pediatri 2010;8:63-6. google scholar
• Kocabas A, Cetinkaya Ozer S, Kardelen F, Ertug H, Akcurin G.; Evaluation of the Skills of Pediatric Residents in Childhood Cardiac Murmurs. Turkish Journal of Pediatric Disease 2013;7:163-7. https://doi.org/10.12956/tjpd.2013.4.01. google scholar
• Türe M, Akın A, Kaya İK, Yavuz Ş.; Üfürüm ile Başvuran Çocukların Ekokardiyografi Sonuçlarının Değerlendirilmesi. Harran Üniversitesi Tıp Fakültesi Dergisi 2021;18:273-8. https://doi.org/10.35440/ hutfd. google scholar
• Kostopoulou E, Dimitriou G, Karatza A.; Cardiac Murmurs in Children: A Challenge For The Primary Care Physician. Current Pediatric Reviews 2019;15:131-8. https://doi.org/10.2174/1573 396315666190321105536. google scholar
• Yıldız J, Çetin İİ, Aktaş D, Arı ME, Kocabaş A, Ekici F, et al.; Is Echocardiographic Evaluation Necessary for all Children with Cardiac Murmur? Turkish Journal of Pediatric Disease 2015. https://doi.org/10.12956/tjpd.2015.158. google scholar
• (TÜİK) TİK.; Doğum İstatistikleri 2021. https://data.tuik.gov.tr/ Bulten/Index?p=Dogum-Istatistikleri-2022-49673#:~:text=Türkiye verisinin kaynağı TÜİK%27tir.&text=Kaba doğum hızı%2C bin nüfus,yılında 12%2C2 doğum düştü. google scholar
• Haq FU, Jalil F, Hashmi SK, Jumani MI, Imdad A, Jabeen M, et al.; Risk factors predisposing to congenital heart defects. Annals of Pediatric Cardiology 2011;4:117-21. https://doi. org/10.4103/0974-2069.84641. google scholar
• Nabulsi MM, Tamim H, Sabbagh M, Obeid MY, Yunis KA, Bitar FF.; Parental consanguinity and congenital heart malformations in a developing country. American Journal of Medical Genetics 2003;116 A:342-7. https://doi.org/10.1002/ajmg.a.10020. google scholar
• Kalisch-Smith JI, Ved N, Sparrow DB.; Environmental risk factors for congenital heart disease. Cold Spring Harbor Perspectives in Biology 2020;12. https://doi.org/10.1101/cshperspect.a037234. google scholar
• Moumne O, Chowdhurry R, Doll C, Pereira N, Hashimi M, Grindrod T, et al.; Mechanism Sharing Between Genetic and Gestational Hypoxia-Induced Cardiac Anomalies. Frontiers in Cardiovascular Medicine 2018;5:1-10. https://doi.org/10.3389/fcvm.2018.00100. google scholar
• Zheng JY, Qiu YG, Li DT, He JC, Chen Y, Cao Y, et al.; Prevalence and composition of CHD at different altitudes in Tibet: A cross-sectional study. Cardiology in the Young 2017;27:1497-503. https://doi. org/10.1017/S1047951117000567. google scholar
• Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü.; 2018 Türkiye Nüfus ve Sağlık Araştırması. Ankara: T.C. Cumhurbaşkanlığı Strateji ve Bütçe Başkanlığı ve TÜBİTAK; 2019. google scholar