OBJECTIVE To assess the cost-effectiveness of various strategies to evaluate heart murmurs in children. METHODS We modeled 6 strategies to follow the initial examination by the pediatrician: (1) refer suspected pathologic murmurs to a cardiologist, (2) obtain a chest radiograph (CXR) and electrocardiogram (ECG) and refer suspected pathologic murmurs to a cardiologist, (3) refer suspected path...

We have presented a two year nonoperative follow-up of an asymptomatic 14-year-old girl with an unusual anomaly of the coronary arteries. Systolic and diastolic murmurs heard preoperatively did not change following severance of a patent ductus arteriosus. Postoperative selective coronary arteriography revealed (1) anomalous orgin of the left anterior descending artery from the right aortic sinu...

Data were analyzed from the U.S. Health Examination Survey (Cycle II) to determine relationships between blood pressure and other characteristics. This survey examined a national probability sample of children aged 6-11 years. Significant relationships were found for blood pressure and the following variables: chronological and skeletal age, skinfold thickness (adiposity) and other anthropometr...

Postoperative cardiovascular studies were carried out in eight patients with ostium primum defect and cleft mitral valve. Apical systolic murmurs were present in all patients, but in seven of them no mitral regurgitation was detected by pulmonary wedge pressure and left ventricular angiography. Surgical repair of the cleft anterior leaflet without resection of subjacent chordae tendineae, as pe...

At physical examinat ion: poor general s tatus, tachydyspneic, pale, weak pulses, especially in the lower limbs. Weight: 2500 g; Height: 48 cm; BP-RSL: 80/40 mm Hg, BP-RIL: 40 mm Hg, HR: 166 bpm, RR: 100 rpm. The aorta was not palpable at the sternal notch. There were mild precordial systolic impulses in the left sternal border and the apical impulse was not palpable. The heart sounds were very...

We have presented a two year nonoperative follow-up of an asymptomatic 14-year-old girl with an unusual anomaly of the coronary arteries. Systolic and diastolic murmurs heard preoperatively did not change following severance of a patent ductus arteriosus. Postoperative selective coronary arteriography revealed (1) anomalous origin of the left anterior descending artery from the right aortic sin...

We have presented a two year nonoperative follow-up of an asymptomatic 14-year-old girl with an unusual anomaly of the coronary arteries. Systolic and diastolic murmurs heard preoperatively did not change following severance of a patent ductus arteriosus. Postoperative selective coronary arteriography revealed (1) anomalous origin of the left anterior descending artery from the right aortic sin...

General condition of the patient with ulcer Most of the patients examined at the hospital, both in the wards and the out-patient department, were poorly nourished, gave a history of repeated attacks of malaria, and were anaemic. Some showed definite clinical evidence of vitamin A deficiency (11 out of 22 cases examined), such as dry papular skin (' phrynoderma '), ichthyotic dry skin, xerosis, ...

We have presented a two year nonoperative follow-up of an asymptomatic 14-year-old girl with an unusual anomaly of the coronary arteries. Systolic and diastolic murmurs heard preoperatively did not change following severance of a patent ductus arteriosus. Postoperative selective coronary arteriography revealed (1) anomalous origin of the left anterior descending artery from the right aortic sin...