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Accurate diagnosis of CHD by Paediatricians with Expertise in Cardiology

Published online by Cambridge University Press:  07 June 2017

Hannah C. Jacob ,
Hannah Massey ,
Robert W. M. Yates  and
A. Wilfred Kelsall
Hannah C. Jacob
Affiliation:
School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
Hannah Massey
Affiliation:
School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
Robert W. M. Yates
Affiliation:
Paediatric Cardiology, Great Ormond Street Hospital, London, United Kingdom
A. Wilfred Kelsall*
Affiliation:
Neonatal Intensive Care Unit, Addenbrooke’s Hospital, Cambridge, United Kingdom
*
Correspondence to: A. W. Kelsall, Neonatal Intensive Care Unit, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 0QQ, United Kingdom. Tel: +01 2232 45151; E-mail: wilf.kelsall@nhs.net
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Abstract

Introduction

Paediatricians with Expertise in Cardiology assess children with a full history, examination, and often perform an echocardiogram. A minority are then referred to an outreach clinic run jointly with a visiting paediatric cardiologist. The accuracy of the echocardiography diagnosis made by the Paediatrician with Expertise in Cardiology is unknown.

Materials and methods

We conducted a retrospective review of clinic letters for children seen in the outreach clinic for the first time between March, 2004 and March, 2011. Children with CHD diagnosed antenatally or elsewhere were excluded. We recorded the echocardiography diagnosis made by the paediatric cardiologist and previously by the Paediatrician with Expertise in Cardiology.

Results

The Paediatrician with Expertise in Cardiology referred 317/3145 (10%) children seen in the local cardiac clinics to the outreach clinic over this period, and among them 296 were eligible for inclusion. Their median age was 1.5 years (range 1 month–15.1 years). For 244 (82%) children, there was complete diagnostic agreement between the Paediatrician with Expertise in Cardiology and the paediatric cardiologist. For 29 (10%) children, the main diagnosis was identical with additional findings made by the paediatric cardiologist. The abnormality had resolved in 17 (6%) cases by the time of clinic attendance. In six (2%) patients, the paediatric cardiologist made a different diagnosis. In total, 138 (47%) patients underwent a surgical or catheter intervention.

Discussion

Paediatricians with Expertise in Cardiology can make accurate diagnoses of CHD in children referred to their clinics. This can allow effective triage of children attending the outreach clinic, making best use of limited specialist resources.

Keywords

Echocardiogrampaediatricianexpertisediagnosis
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 6 , August 2017 , pp. 1140 - 1145
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Copyright
© Cambridge University Press 2017 

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