Dhafer O Alqahtani, Ali A Alakfash, Omar R Altamim.
The Pre-operative Assessment of Acyanotic Pediatric Patients Presented with Heart Murmur and Role of Surgry in congenital heart diseases, A retrospective analysis.
Pak J Surg Jan ;31(3):179-84.

Objectives: Th e aim of this study is to evaluate the incidence of congenital heart disease in patients referred solely because of heart murmur in pediatric age group and to assess the rule of medical and surgical management in patient with heart defects. Study design: It is retrospective analysis of all paediatric cases who presented with cardiac murmur. Materials and Methods:A retrospective database and echocardiographic review. All patients referred to King Abdulaziz Cardiac Center (KA CC) Riyadh, Kingdom of Saudi Arabia during the period from July 2007 till March 2009 for cardiovascular evaluation because of heart murmur detected during routine physical exam. We included any pediatric patient from the neonatal period till 14 years of age who had echocardiography in our center. Any patient with cyanosis, those with diff erence in the blood pressure between the upper limbs and lower limbs of more than 15 mmHg, preterm neonates, any acquired heart disease and syndromic and critically ill patients were excluded from the study. Results: A total of 245 patients met the inclusion criteria. Median age and weight is 7 months (one day – 12 years), 7.85 Kg (1.9 – 54 Kg) respectively. Normal echocardiography was present in 163 patients (66.5%). Th e most encountered anomaly found was patent ductus arteriosious (PDA) which was diagnosed in 27 patients (11 %) followed by atrial septal defect (ASD) secundum in 26 patients (10.6%), then the VSD in 22 patients (9%), atrio-ventricular septal defect (AVSD) in 1 patient (0.4%), Coarctation of Aorta in 3 patients (1.2%), Tortuous of arch in 1 patients (0.4%), Pulmonary stenosis in 10 patients (4%), Mitral valve prolapse in 4 patients (1.6%) and the false tendon in 6 patients (2.4 %). The intervention by cardiac catheterization was done for 10 patients (4%). Surgical repair done in fi ve patients (2%). Th e spontaneous closure was observed in 31 patients (12.7%). Th ere was 7 patients (2.9%) missed follow up. Conclusions: The prevalence of congenital heart disease in acyanotic pediatric patients referred with Heart murmur is signifi cantly high in Saudi population.

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