Red Flags for Cardiac Examination for Early Detection of Congenital Heart Disease

The Relation Between the Presence of Abnormal Clinical Cardiac Findings and Echocardiographic Findings in Newborn Infants

The study done to identify the relation between the presence of abnormal clinical cardiac findings and the echocardiographic findings in newborn infants.

A full history will be taken, complete general systemic and cardiac examination will be done. All patients with abnormal physical cardiac examination in the neonatal period (≤ 28 days of age) according to the inclusion criteria will have echocardiographic examination.

Inclusion Criteria:

• • Abnormal heart rate (< 90/min or < 160 per min )

  • Comfortable tachypnea ( RR > 60/min without other manifestations of respiratory distress)
  • Abnormal heart sounds (muffled, accentuated, single )
  • Abnormal precordial activity
  • Murmur: ( ≥ grade 3 intenisty, holosystolic timing, maximum intensity at upper left sternal border or with upright positing, diastolic murmur, harsh or blowing quality )
  • Abnormal oxygen saturation <90% in any extremity Oxygen saturation gradient > 3% difference in extremities.
  • Blood pressure gradient >10 mmHg higher in arms >10 mmHg lower in legs
  • Abnormal femoral pulses
  • Weakened pulses
  • Absent pulses
  • Hepatomegaly
  • Family history of cardiac disease

Exclusion Criteria:

• Newborns with disorders affecting the heart as anemia, septicemia, respiratory disorders as respiratory distress syndrome, pneumonia, hypoplastic lung, renal impairment, hypertension, metabolic disease, syndromatic CHF