2002, Number 3
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Rev Mex Pediatr 2002; 69 (3)
Sensibility and specificity of the clinical diagnosis of congenital heart diseases
Flores AA, Gómez LFA, Valles RR, Rodríguez TG, Flores VS, Alonso AR
Language: Spanish
References: 10
Page: 99-101
PDF size: 47.05 Kb.
ABSTRACT
Objective. To study the sensibility and specificity of the clinical diagnosis of congenital heart disease, made by two pediatric cardiologists, taking as “a gold standard” an echocardiographic report.
Material and methods. It is a retrospective study done in 150 children whose the clinical diagnosis, with support of electrocardiographic study and a X-ray of the thorax, was contrasted with an echocardiogram result. The diagnoses obtained with both procedure were qualified as positive or negative, according to that was confirmed the presence or absence of some cardiac anomaly.
Results. The sensibility was 84.8%, with a positive predictive value of 79.6%, and the sensibility was of 65.6%, with a negative predictive value of 73.1%. Although these percentages seem reasonably high, the probabilities of a positive diagnosis (2.5) and a negative diagnosis 0.23, to the clinical decision have a limited value.
Conclusions. It is suggested that before the smallest doubt gleam in the clinical diagnosis an echocardiogram is requested.
REFERENCES
Smythe JF. Initial evaluation of the heart murmurs: Are laboratory test necessary? Pediatrics 1990; 86: 497-500.
Swenson JM, Fisher DR, Miller SA, Boyle GJ, Ettedgui JA, Beerman LB. Ares chest radiographs and electrocardiograms still valuable in evaluating new pediatric patient with heart murmurs or chest pain? Pediatric 1997; 99: 1-3.
Díaz GD, Attie F, Quero JM. Secuencia diagnóstica de las cardiopatías congénitas. Arch Inst Cardiol Méx 1982; 52: 69-76.
Rodríguez LDM, Vizcaíno AA. Aplicación clínica de la ecocardiografía en la edad pediátrica. Bol Med Hosp Infan Méx 1990; 47: 611-619.
Duran MM, Larman M, Trufeda A, Vázquez AJP, Javier Ruano J, Torres A, Figueroa A, Pajaron A, Nistal F. Comparison of Doppler-determined elevate pulmonary arterial pressure with pressure measured at cardiac catheterization. Am J Cardiol 1986; 57: 859-863.
Zeller T, Gutgesell HP. Non invasive stimation of pulmonary artery pressure. J Pediatrics 1989; 114: 735-740.
Greenberg RS, Daniels SR, Flanders WD, Eley W, Boring JR, 3ra ed. México: Manual Moderno, 2002.
Hirashi S. Two dimensional Doppler echocardiographic assessment of closure of the ductus arteriosus in normal newborn infants. J Pediatrics 1987; 11: 755-760.
Pedra CA, Fontes-Pedra SR, Esteves CA, Aseef J, Fontes UF, Hijazi ZM. Multiple atrial septal defects and patent ductus arteriosus: successful outcome using two Amplatzer septal occluders and Gianturco coils. Cathet Cardiovasc Diagn 1998; 45(3): 257-9.
Marwah A, Radhakrishnan S, Shrivastava S. Immediate and early results of closure of moderate to large patent arterial ducts using the new Amplatzer device. Cardiol Young 2000; 10(3): 208-11.
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