When to call the cardiologist: treatment approaches to neonatal heart murmur.

Moderate and severe forms of congenital heart disease (CHD) occur in about 6 per 1,000 live births. If tiny muscular ventricular septal defect (VSD) and bicuspid aortic valve as well as other lesions of a less serious nature are included, it is estimated that the true incidence of congenital heart disease might be as high as 75 per 1,000 live births.1 CHD is a leading cause of infant mortality in United States.2 Early detection and prompt intervention is critical in reducing infant mortality associated with CHD. Careful clinical examination is extremely important and is always the first step in ruling out CHD. It is not infrequent to find a heart murmur while examining a baby in the newborn nursery. The clinician is then faced with a deciWhen to Call the Cardiologist: Treatment Approaches to Neonatal Heart Murmur