Özet:

Objective: Cardiac murmurs are the most common reason of referral to a pediatric cardiologist worldwide, despite the fact that almost a half the cardiac murmurs in childhood is innocent. In our study we aimed to establish the performance of our pediatric residents are evaluating a child with cardiac murmur, and the tendency of claiming telecardiography, electrocardiography and echocardiography in order to confirm their clinical diagnosis.Material and Methods: The patients presented with cardiac murmur were evaluated by pediatric residents. Preliminary diagnoses and claimed tests were asked according to their medical history and physical examinations. These parameters were compared with the final diagnoses after evaluation by pediatric cardiologists and echocardiography.results: The performance of our pediatric residents in terms of distinguishing pathological and innocent murmurs was suboptimal (75.9%) and did not show any improvement with the duration of education or pediatric cardiology rotation. Although the ‘true positive’ results for pathologic murmurs were high in both high and low seniority groups (93.6% and 93.0%, respectively), incapability of diagnosing innocent murmurs caused the total performance to be lower. The highest true positive ratios were for ventricular septal defects (83.3%), while innocent murmurs were correctly diognesed by 58.6% and misdiagnosed as atrial septal defects by 25.9%. For both pathological and innocent murmurs, echocardiography was the most frequently claimed test, with the ratio of %41.9 even for the innocent murmurs. conclusion: History taking and clinical evaluation are still of critical importance even in the light of current advance in new diagnostic tools in distinguishing the pathological and innocent murmurs. Thus, our pediatric residents should improve their skills in evaluating cardiac murmurs and the strategies of pediatric cardiology education must be scrutinized through that issue

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