Valor diagnostico del electrocardiograma en las cardiopatías congénitas del neonato

Abstract

INTRODUCTION: Currently, congenital heart disease are major causes of morbidity and mortality in our country are the second leading cause, preceded only by prematurity and its complications. A tentative diagnosis of congenital heart disease (CHD) should be directed toward first‐level steps to be referred to time and appropriate level for prompt and adequate treatment. OBJECTIVE: To assess the diagnostic value of the electrocardiogram in heart disease of the newborn. MATERIAL AND METHODS: We conducted a multicenter, ambiespective diagnostic test designed to 325 newborns of both sexes, healthy and valuation CPC attending the pediatric cardiology service from Central Military Hospital, Specialty Clinic Women's Hospital Regional and Hospital Infantil de Mexico "Dr. Federico Gomez. " We value the electrocardiogram in a blinded fashion, compared with the reference standard is the transthoracic echocardiogram. RESULTS: Female patients were 46% and 54% male, mean age at birth of 38.0 ± 2.64 weeks gestational age, age of patients at the time of revision was 13.85 ± 10.21 days. 19.5% were premature, 80% of term infants and 0.5% of preterm infants. The heart was normal in 39%, heart rating: 16%, grade II heart disease: heart disease 12% and grade III: 33%. The calculation of the diagnostic test was with a sensitivity of 72%, specificity of 71%, PPV: 80% PVN: 60%, LR +: 2.48 and LR‐: 0.39. The diagnostic test for congenital heart disease was sensitivity 89%, specificity 98%, PPV: 96%, NPV: 95%, LR +: 65 and LR‐: 0.10. CONCLUSIONS: The electrocardiogram as a diagnostic test for congenital heart disease of the newborn is acceptable for initial assessment, improvement when used in serious and complex heart disease, but are recommended for use with other diagnostic parameter.