%0 Journal Article
%A Rodríguez-González, Moisés
%A Alonso-Ojembarrena, Almudena
%A Castellano-Martínez, Ana
%A Estepa-Pedregosa, Lorena
%A Benavente-Fernández, Isabel
%A Lubián López, Simon P
%T [Heart murmur in children less than 2 years-old: looking for a safe and effective referral strategy].
%D 2018
%U http://hdl.handle.net/10668/12510
%X Current guidelines in Spain recommend performing transthoracic echocardiography (TTE) in all children under 2 years of age with a heart murmur. In 2014, the American Paediatric Association published the first appropriate use criteria (AUC) for outpatient paediatric transthoracic echocardiography (TTE) to promote its cost-efficient use. The aim of this article is to analyse the AUC and other clinical factors as predictors of congenital heart disease (CHD) in children less than 2 years of age with a heart murmur, and to develop a safe and efficient referral strategy. Case-control study conducted with children less than 2 years of age, referred from Paediatric Primary Care to Paediatric Cardiology during a 4-year study. A predictive model for CHD was determined using multivariate analysis. A total of 688 patients were included, with 129 (19%) cases of CHD. An age less than 3 months (adjusted odds ratio [ORa] 3.8 [1.5-8.4], p=.030) and fulfilling AUC (ORa 16.3 [9.4-28.3], p To refer children less than 3 months old, fulfilling AUC, without a concurrent infection, or without negative neonatal pulse oximetry screening, is a safe and efficient strategy for the management of heart murmur in children under 2 years of age.
%K Cardiopatías congénitas
%K Congenital heart disease
%K Echocardiography
%K Ecocardiografía
%K Heart murmur
%K Soplo cardiaco
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