Current practice of the management of asymptomatic heart murmurs in neonates in UK

Background Heart murmur is present in approximately 10% of babies on routine postnatal examination. Currently, various investigational approaches are undertaken in asymptomatic heart murmur to identify babies who might have a significant congenital heart disease (CHD). Aim To evaluate the current practice of the management asymptomatic heart murmurs in UK. Methods In August–September 2010 we undertook a telephone survey of neonatal units in UK enquiring about the investigations utilised in the assessment of asymptomatic heart murmurs. Results 116 units participated in the survey. Of this 24 were from Level 1, 52 from Level 2 and 40 from Level 3 units. The survey was predominantly answered by registrars. The majority of units undertake pulse oximetry and blood pressure measurement. There some units still doing chest x-rays (32) and ECGs (40) in asymptomatic heart murmurs. In-house echocardiography skills were available in 46% of Level 1, 67% Level 2 and 80% Level 3 units. Despite this only a handful of units echo asymptomatic babies with heart murmur before discharge home. Conclusion Currently there is a spectrum of practice in the management of asymptomatic heart murmur in neonates in UK. The majority use pulse oximetry and blood pressure measurements. There is very little evidence for doing ECGs and CXRs in asymptomatic babies which is supported by the findings of the survey. We hope this survey would help support the current evidence in the proposal of a consensus based guidelines for the management of asymptomatic heart murmur in UK.