Pediatric Congenital Heart Disease Evaluation

In this cross-sectional study, 1272 pediatric patients under 16 years who were referred for follow-up of a known congenital heart defect (before or after a corrective surgery) or for evaluation of a possible congenital heart disease between April 2021 and February 2022, to a pediatric cardiology clinic in Mofid Children Hospital, Tehran, Iran were enrolled. Characteristics of the patients, including their medical histories and diagnosis, were obtained from the parents and if needed from the electronic medical record system of our center. All the patients were examined by a single experienced pediatric cardiologist using a conventional stethoscope at the first step and a Doppler Phonolyser device at the second step. In this regard, while the patient was in the supine position, an Ultrasound 2 MHz probe of a Doppler Phonolyser device was firmly secured on the chest for 30 s in each of four usual auscultatory areas. The Doppler Phonolyser’s results were interpreted based on the Doppler graph (Fig. 2). A checklist in which the patients were classified based on the auscultation findings as well as Doppler Phonolyser findings in three groups (normal, innocent murmur and pathologic murmur) was completed. A second pediatric cardiologist blindly re-examined 120 patients of the total patients with the Doppler Phonolyser device and the findings were recorded in a second checklist. Afterward, the patient underwent trans-thoracic echocardiography with either a GE Vivid S60 or a Samsung HS70 echocardiographic system. The echocardiogram was interpreted without the knowledge of Doppler Phonolyser results. The echocardiogram was considered normal if there was no pathologic finding other than mild tricuspid or pulmonary regurgitation.
Consent for participation was obtained from the parents of the participants and the protocol was conducted in compliance with the Declaration of Helsinki and approved by the Ethical committee of Shahid Beheshti University of Medical Science (Ethics approval number: IR.SBMU.MSP.REC.1400.641).