50 years ago in the journal of pediatrics: The incidence of murmurs in healthy premature infants during their first 18 months of life

摘要

Heart murmurs are common in normal newborn infants. It is estimated that at least 50% of all normal newborns will have a heart murmur during the first few months of life. The majority of these murmurs are so called innocent murmurs and do not reflect pathology. These murmurs also may be caused by peripheral arterial pulmonary stenosis or a very small ventricular defect. Both these murmurs will disappear with the infant's growth and are not cause for concern. These full term infants have normal cardiovascular systems and are seldom referred to a cardiologist for evaluation. However, if the baby is premature a patent ductus arteriosus or other significant heart disease maybe present and further evaluation may be indicated. Usually, these infants will have an echocardiogram to confirm the diagnosis. In 1963, clinicians knew that full term infants frequently had innocent murmurs but the incidence of such murmurs in infants weighing less than 2000 g was unknown. Walsh followed 82 healthy premature infants for the first 18 months of their lives and found that 82% had murmurs at some point. Four percent of these infants had significant congenital heart disease, which is a higher incidence than that found in full term infants. This was the first study that followed premature infants for heart disease in this fashion and alerted clinicians to the fact that although the majority of these infants have innocent murmurs, some do have significant heart disease. Today, a simple echocardiogram can rule out a significant diagnosis in this population.