بررسي شيوع علل و عوامل زمينه اي سوفل ها و صداهاي اضافي قلبي در دانش آموزان كلاس اول دبستان هاي شهر رشت (سال 86-1385)

Survey of Prevalence, Etiology and Associated Factors of Heart Murmurs and Extrasounds in the First-Grade Students in Rasht, 2006-7

Introduction: Heart murmurs are common findings of physical examination of children, but most of them are, innocent. Recognizing the etiology and associated factors with heart munnurs can help us in differential diagnosis of them. In attention to high prevalence of heart murmurs and low prevalence of congenital heart diseases in children, diagnosis of the innocent murmur with pathologic murmur is important. Objective: Determine the prevalence of heart murmurs and extra sounds, etiology and associated factors in the heart of the first-grade students in Rasht, 2006-7. Materials and Methods: This cross-sectional study was performed on 4080 first-grade students in Rasht. At first, all students were examined by educated physicians and the cases with positive findings in cardiovascular examination Were referred to the clinic of pediatric cardiology hospital. Echocardiography, Electrocardiography ! and if it was necessary Chest X ray, Angiography and Laboratory evaluations were performed for the students with a murmur and heart extra sound who were examined by pediatric cardiologist. Following the determination of definitive diagnosis and complementary history from the parents of the children, all collected data were analyzed by SPSS 15. Results: Among 4080 students (2055 boys,2025girls), 320students (7.8%) had a heart murmur and extra sound that among of them 292 students(7.15%) had a murmur and 52 students (1.27%) bad a extra sound .The prevalence of innocent and pathologic murmurs in the girls were (4.88% and 2.12%) and in the boys were (4.91% and 2.38%), respectively The prevalence of congenital heart diseases (except MYP) were 1.8%. including MR (0.93%), TR (0.51%), TVP (0.147%), VSD (0.12%), PS (0.12%), ASD (0.07%), PI (0.07%),AS(0.02%),PDA(O.02%),PPH(O.02%) and Ebstein anomaly (0.02%). The prevalence of MVP was 2.38% and in the girls it was 1.2 times more than in the boys (p