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Accuracy of Physical Examination for Diagnosing Pulmonary Arterial Hypertension in Congenital Heart Disease Children

Amar Taksande, Professor, Dept. of Pediatrics, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha, Maharashtra 442004, India. , Akshi Gandhi1 , Amar Taksande2

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Pediatric Education and Research 6(1):p 17-20, Jan-Apr 2018. | DOI: https://dx.doi.org/10.21088/per.2321.1644.6118.3

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Abstract

Background: Pulmonary Hypertension is a complex problem characterized by non-specific signs and symptoms and having multiple potential causes. Delays in the diagnosis of PAH lead to postponement of treatment and thus may have deleterious effects. Aims: To determine the accuracy of physical examination (palpable second heart sound, dullness over pulmonary area, loud second heart sound) for diagnosing pulmonary hypertension in Congenital Heart Disease Children. Materials and Methods: A Cross Sectional Study in Department of Pediatrics at AVBRH, Sawangi , Wardha. 3 pediatric residents, trained by a cardiologist for detection of Pulmonary Hypertension in CHD cases assessed 140 clinically suspected CHD cases, looked for palpable second heart sound (P2), Dullness over pulmonary area, Loud second heart sound on auscultation. Their findings were correlated with 2 Dimensional Echocardiography. Data was entered into SPSS for Windows, Version 22 and Graph pad Prism 6.0 version for statistical analysis. To know the true positive cases, true negative cases, probability that the cases with positive physical examination truly have PAH probability that the cases with negative physical examination truly don’t have PAH for which 2x2 contingency tables were formed. Results: Out of 140 cases of CHDs, 41 cases (29.2%) had Pulmonary hypertension. All the Physical markers are equally effective in analyzing pulmonary hypertension as predictive values are nearly equal, and there is no significant difference in their findings. Conclusions: we demonstrate that physical examination are effective in diagnosing the presence of PAH in CHD children.

Keywords: Pulmonary Hypertension; Heart Sound; Palpable Second Heart Sound (P2); Echocardiography. 

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DOI: https://dx.doi.org/10.21088/per.2321.1644.6118.3

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