Accuracy of Physical Examination in Distinguish Pathologic Murmur of non Pathologic

Abstract Background & aim: Cardiac auscultation is one of the most useful investigative tools that the physician may use at the bedside to detect alterations in cardiovascular anatomy and physiology. However, the sensitivity and specificity vary substantially with the expertise of the examiner. The aim of this study comparing the initial evaluations of heart murmurs in neonates between neonatologist and pediatric cardiologist. Methods: This cross-sectional study was conducted on 108 neonates admitted in Be’sat and Fatemieh Hospitals of Hamadan, Iran, in 2010. First, a neonatologist recorded their clinical evaluation (Pathologic, Likely pathologic, Innocent). Then, a Pediatric cardiologist recorded the infants’ clinical evaluation. Finally, echocardiography study was performed by the cardiologists for final diagnosis. The data were analyzed by SPSS version 16 and the using Chi-square. Results: In this study, 67 patients (62%) had pathologic murmur. Clinical findings of pathological murmur by neonatologist and cardiologist are 98% sensitivity versus 87/2% 84/2% specificity vs. 100% 94/1% the positive predictive value vs. 100% and 94% negative predictive value vs. 85.4%, respectively. Conclusion: Evaluations of examination show no significant difference between neonatologists and cardiologists. Hence, echocardiography is the standard for establishing the cause of murmur. Key words: Murmur, Echocardiogram, Physical Examinatio