Original ArticlesParental anxiety associated with referral of a child to a pediatric cardiologist for evaluation of a Still's murmur☆
Section snippets
Study population
Participants in this study consisted of 122 parents of 95 pediatric patients referred to one of 6 outpatient satellite clinics. Data were collected throughout a 12-month period beginning in July 1999. Parents were asked to participate if their child was >1 year old, had no previous pediatric cardiology evaluation, had no cardiac symptoms, had a normal electrocardiogram, and was diagnosed to have a Still's murmur and no structural heart disease by the cardiologist. The diagnosis of a Still's
Study group
Most of the parents were female, white, and had completed college (Table I). Data in parentheses represent percent.Parent Age (y), (mean ± SD); median (range) 35 ± 4.9 35 (25-46) Gender (F) 64 (67) Education level ≥college 59 (62) White 88 (93) Family history of heart disease 61 (64) Family history of innocent murmur 54 (57) Child Age (y), (mean ± SD); median (range) 4.6 ± 3.0 4.0 (1-14) First-born or only child 46 (48) Other medical condition 33 (35) Murmur detected <3 y 53 (56)
Discussion
This study indicates that many parents whose children are referred to a pediatric cardiologist for evaluation of a Still's murmur are anxious about multiple aspects of their child's health. Many parents are unaware that murmurs in children can be benign and transient,21 or that heart disease in children usually is not associated with myocardial infarction or sudden death as can occur in adult coronary artery disease.10 Parental anxiety may contribute to the parent's view of the child as
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Evaluation of heart murmurs in children
2022, Progress in Pediatric CardiologyCitation Excerpt :Of equal importance is the parental anxiety that results, as they often associate heart murmurs with heart disease [3]. Clinicians are aware that there are several types of physiologic murmurs of childhood, but many parents are unaware that most murmurs in children are benign and transient [3]. Families who are referred to a pediatric cardiologist for evaluation are anxious about multiple aspects of their child's health, including the need for medication, sports restrictions, potential cardiac surgery, cardiac risk for siblings, and even premature death [3].
Evaluating Chest Pain and Heart Murmurs in Pediatric and Adolescent Patients
2020, Pediatric Clinics of North AmericaCitation Excerpt :The result is the mystification of auscultation. Furthermore, in health care today expensive testing is highly scrutinized, and there is pressure to use medical resources in a responsible manner while avoiding anxiety created by referral to subspecialists.42–44 Physical examination and auscultation are cost-effective, safe, and accurate in the hands of a skilled practitioner.45,46
Heart murmur in children less than 2 years-old: looking for a safe and effective referral strategy
2018, Anales de PediatriaComparative Analysis: Implementation of a Pre-operative Educational Intervention to Decrease Anxiety Among Parents of Children With Congenital Heart Disease
2017, Journal of Pediatric NursingCitation Excerpt :The STAI has been employed both in the clinical setting to diagnose anxiety and distinguish it from depressive syndromes (Sala et al., 2011; Shimpuku et al., 2014), and in the research setting in order to identify caregiver stress (Iavarone, Ziello, Pastore, Fasanaro, & Poderico, 2014). It has also been used to evaluate parental anxiety in specific areas of paediatric cardiology (Geggel et al., 2002). A tool developed by our research group was used to collect information on the socio-demographic characteristics of our study participants, including their gender, age, and marital status.
Heart murmurs in asymptomatic children: When should you refer?
2016, Archives de PediatrieMatrix decomposition based feature extraction for murmur classification
2012, Medical Engineering and PhysicsCitation Excerpt :Heart murmurs frequently appear in children, and fortunately, most heart murmurs that are detected in children are innocent [5–7]. To reduce unnecessary parental anxiety, it is important to recognize an innocent murmur as soon as it is found [8,9]. However, because of the difficulty of mastering auscultation skills, innocent and organic heart murmurs cannot be readily distinguished [10–12].
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Reprint requests: Robert L. Geggel, MD, Department of Cardiology, Children's Hospital, 300 Longwood Ave, Boston, MA 02115.