Purpose - To determine the prevalence of innocent murmur among adolescents, and to evaluate the clinical features in comparison with echocardiogram (two-dimensional, M-mode, Doppler, and color-Doppler) in the assessment of heart murmurs. Methods - The study was carried out from March to December, 1992, and involved high school students coming from families of the medium and low-medium social classes. Considering the total of 1400 students registered in a public school, 536 adolescents aging from 10 to 20 years were admitted in this study. Twenty seven students with heart murmur were submitted to Echocardiography in order to find any cardiac lesions. Results - Among 536 adolescents, 171 (32%) had some kind of heart murmur. On the basis of the clinical diagnosis, 160 (29,9%) patients were classified as having innocent murmur and 11 (2,1%) as having -pathologic murmur-. Out of 27 students submitted to echocardiography, 20 of them with clinical diagnosis of innocent murmur showed normal results. Among seven students with clinical diagnosis of -pathologic murmur-, the echocardiography recognized cardiac lesions in two (small ventricular septal defect and rheumatic heart disease: combined mitral incompetence and stenosis, and aortic incompetence). Conclusion - From the data obtained, the prevalence of innocent murmur among adolescents was 29,9% on the basis of clinical diagnosis. It is suggested that careful clinical examination by physicians skilled in cardiac examination is the recommended method for the diagnosis of innocent murmur (sensitivity of 100% and specificity of 80%).
Purpose -To determine the prevalence of innocent murmur among adolescents, and to evaluate the clinical features in comparison with echocardiogram (two-dimensional, M-mode, Doppler, and color-Doppler) in the assessment of heart murmurs. Methods - The study was carried out from March to December, 1992, and involved high school students coming from families of the medium and low-medium social classes. Considering the total of 1400 students registered in a public school, 536 adolescents aging from 10 to 20 years were admitted in this study. Twenty seven students with heart murmur were submitted to Echocardiography in order to find any cardiac lesions. Results - Among 536 adolescents, 171 (32%) had some kind of heart murmur. On the basis of the clinical diagnosis, 160 (29,9%) patients were classified as having innocent murmur and 11 (2,1%) as having -pathologic murmur-. Out of 27 students submitted to echocardiography, 20 of them with clinical diagnosis of innocent murmur showed normal results. Among seven students with clinical diagnosis of -pathologic murmur-, the echocardiography recognized cardiac lesions in two (small ventricular septal defect and rheumatic heart disease: combined mitral incompetence and stenosis, and aortic incompetence). Conclusion - From the data obtained, the prevalence of innocent murmur among adolescents was 29,9% on the basis of clinical diagnosis. It is suggested that careful clinical examination by physicians skilled in cardiac examination is the recommended method for the diagnosis of innocent murmur (sensitivity of 100% and specificity of 80%).
Methods -The study was carried out from March to December, 1992, and involved high school students coming from families of the medium and low-medium social classes. Considering the total of 1400 students registered in a public school, 536 adolescents aging from 10 to 20 years were admitted in this study. Twenty seven students with heart murmur were submitted to Echocardiography in order to find any cardiac lesions. Results - Among 536 adolescents, 171 (32%) had some kind of heart murmur. On the basis of the clinical diagnosis, 160 (29,9%) patients were classified as having innocent murmur and 11 (2,1%) as having -pathologic murmur-. Out of 27 students submitted to echocardiography, 20 of them with clinical diagnosis of innocent murmur showed normal results. Among seven students with clinical diagnosis of -pathologic murmur-, the echocardiography recognized cardiac lesions in two (small ventricular septal defect and rheumatic heart disease: combined mitral incompetence and stenosis, and aortic incompetence). Conclusion - From the data obtained, the prevalence of innocent murmur among adolescents was 29,9% on the basis of clinical diagnosis. It is suggested that careful clinical examination by physicians skilled in cardiac examination is the recommended method for the diagnosis of innocent murmur (sensitivity of 100% and specificity of 80%).
Results -Among 536 adolescents, 171 (32%) had some kind of heart murmur. On the basis of the clinical diagnosis, 160 (29,9%) patients were classified as having innocent murmur and 11 (2,1%) as having -pathologic murmur-. Out of 27 students submitted to echocardiography, 20 of them with clinical diagnosis of innocent murmur showed normal results. Among seven students with clinical diagnosis of -pathologic murmur-, the echocardiography recognized cardiac lesions in two (small ventricular septal defect and rheumatic heart disease: combined mitral incompetence and stenosis, and aortic incompetence). Conclusion - From the data obtained, the prevalence of innocent murmur among adolescents was 29,9% on the basis of clinical diagnosis. It is suggested that careful clinical examination by physicians skilled in cardiac examination is the recommended method for the diagnosis of innocent murmur (sensitivity of 100% and specificity of 80%).
Conclusion -From the data obtained, the prevalence of innocent murmur among adolescents was 29,9% on the basis of clinical diagnosis. It is suggested that careful clinical examination by physicians skilled in cardiac examination is the recommended method for the diagnosis of innocent murmur (sensitivity of 100% and specificity of 80%).
Determinar a prevalência de sopro inocente em adolescentes, avaliando a importância do exame clínico no diagnóstico do mesmo, tendo como -padrão ouro- o estudo Doppler-ecocardiográfico.
Método -Este estudo, realizado no período de março a dezembro de 1992, abordou alunos de primeiro e segundo graus, com idade entre 10 e 20 anos, oriundos de famílias de classes média e média-baixa. Os 536 participantes foram selecionados a partir da randomização dos 1400 alunos matriculados. Os alunos sorteados foram entrevistados e examinados por um dos pesquisadores, sendo que 27 crianças com sopro cardíaco foram submetidas a estudo Doppler-ecocardiográfico.
Resultados -Dos 536 alunos examinados, 171 (32%) apresentavam algum tipo de sopro cardíaco, sendo que 160 (29,9%) foram considerados como portadores de sopro inocente, e 11 (2,1%) de -sopro não inocente-. Dentre os 27 adolescentes com sopro que foram submetidos a estudo Doppler-ecocardiográfico, em 20 esse exame confirmou o diagnóstico clínico de sopro inocente, não evidenciando qualquer anormalidade ou sendo visibilizados achados considerados fisiológicos. Das sete crianças com diagnóstico clínico de -sopro não inocente-, o estudo Doppler-ecocardiográfico demonstrou lesão cardíaca em dois (pequena comunicação interventricular e valvopatia reumática: dupla lesão mitral e insuficiência aórtica) e dados anátomo-funcionais normais em cinco.
Conclusão -Diante dos resultados obtidos, a prevalência global de sopro inocente em adolescentes foi calculada em 29,9%. Sugere-se o exame clínico bem feito, realizado por médicos treinados em semiologia cardiovascular, é capaz de definir o diagnóstico de sopro inocente na maioria dos casos (sensibilidade de 100% e especificidade de 80%).
