Results analysis of community child health examinations in 272 cases of at risk children with heart murmur

AIM:To preliminarily study the importance of health care and physical examination from the community health service center for infants and children aged 0 to 6 years old in disease screening, especially for heart disease. METHODS: Two hundred seventy-two at-risk infants and children aged 0 to 6 years old with auscultated cardiac murmur during physical examination carried out at the district belonging to the community health service center from July 2009 to June 2013 were registered for project management. Children were transferred to the superior specialized hospital for cardiac color ultrasound and myocardial enzyme examintions to identify the causes of heart murmur and the disease. RESULTS: According to the diagnostic results of the specialized cardiovascular hospital for the 272 at-risk infants and children aged 0 to 6 years old with auscultated cardiac murmur, 124 cases were pathological murmur (45.6%) and 148 (54.4%) cases were physiological murmur. In the infants and children with pathological murmur, 85 cases were diagnosed as congenital heart disease (31.3%) including 62 cases (22.8%) of ventricular septal defect (VSD), 13 cases (4.8%) of atrial septum defect (ASD), two cases (0.7%) of atrioventricular septal defect and ten cases (3.7%) of patent ductus arteriosus (PDA); 37 cases (13.6%) were secondary heart disease including 27 cases (9.9%) of infectious myocardial damage, two cases (0.7%) of myocarditis, one case (0.4%) of infectious endocarditis and seven cases (25.7%) of anemic heart disease; 148 cases were physiological murmur including 42 cases (15.4%) of left ventricular false tendons, 42 cases (15.4%) of valvular regurgitation and prolapse, and 64 cases (23.5%) with no abnormalities. The proportion of congenital heart vascular disease in the group aged <1 year was significantly higher than the group aged >1 year and even higher than the group aged >2 years (both P<0.01). The proportions of secondary heart disease and physiological murmur in the group aged <1 year was significantly lower than the groups aged >1 year and 2 years (both P<0.01). The proportion of congenital vascular heart disease in the group aged <1 year was significantly higher than the proportions of secondary heart disease and physiologic murmur. CONCLUSION: The proportions of congenital heart disease and secondary heart disease of infants and children with auscultated cardiac murmur in the physical examination for community health care were better diagnosed in the specialized referral hospital. Free and regular health care and physical examination from the community health service center for atrisk infants and children every year plays an important and positive role in the child’s growth and disease screening; therefore, careful and early primary health care can reveal childhood diseases in order to obtain timely treatment.