Heart Murmur Case Study

Synopsis Detection of heart murmur in children is a common occurrence, and is frequently benign. However, concern over serious pathology is a ubiquitous response by parents and guardians and is often not abated until thorough evaluation by a pediatric cardiologist has been performed. Given the frequent delay in assessment by a pediatric cardiologist, the authors performed an observational/interventional study of parents or guardians of otherwise healthy children (n= 258 parents/guardians=178 children) referred for evaluation of murmur designed to measure anxiety level after referral, and whether this anxiety could be reduced by provision of a fact sheet delineating the specifics of heart murmurs in the pediatric population. Mean anxiety levels were measured 2 weeks prior to consultation and 2 weeks after consultation. Prior to consultation, 60% of parents/guardians were determined to have an increased anxiety level as measured by the State Trait Anxiety Index, with a mean score of 34.9, which decreased to 30.9 …show more content…
Fewer parents in the intervention group believed their child would have increased risk of heart disease later in life (p = 0.04) or that heart murmurs in children represents valvular-or congenital heart disease (p = 0.02).
Consequently, it was determined that providing a fact sheet to parents prior to consultation did not significantly reduce anxiety levels, but did improve overall knowledge regarding pediatric heart murmurs and quell certain concerns. However, the study revealed that the only significant reduction in overall anxiety was provided by consultation with the pediatric cardiologist. The level of anxiety also increased with lower age of the child, lower education level of parent/guardian, major concern, and prior anxiety of parent/guardian.