Abstract

COSTA, Ana Margarida et al. Echocardiogram by telemedicine in the newborn in a level II hospital: a review of four years. Nascer e Crescer [online]. 2011, vol.20, n.3, pp.137-140. ISSN 0872-0754.

Introduction: The Echocardiogram by Telemedicine (EcoTM) between the pediatric department of a level 2 hospital and the pediatric cardiology service of a level 3 hospital began in October 2005. Objective: To characterize the newborns (NB) who under­went EchoTM and emphasize the importance of this practice in the management of the patients. Methods: The authors reviewed the reports of EchoTM conducted between October 1, 2005 and September 30, 2009. The following variables were analyzed: age, sex, reason for the exam, diagnosis and orientation. Results: During this period, 139 EchoTM were done on 122 NB (1.71% of our live NB). Male patients predominated (57%). EchoTM was performed before discharge from the maternity in 30,9% and during the first week in 50%; it was urgent in 11 cases. The most frequent motives for EchoTM: asymptomatic heart murmur (68,3%), pervious abnormal EchoTM (11,5%), malformations (5,8%) and hypoxia (3,6%). The most frequent diagnosis were: ventricular septal defect (VSD) (31.3%), inter-auricular communication (25.8%) and patent ductus arteriosus (7%). Six infants were transferred (simple transposition of greater arteries (n=2), single ventricle (n=1), malformation of the aortic arch (n=1), aortic coarctation (n=1) and large sub-aortic VSD (n=1). In 26.6% it was excluded cardiopathy. EchoTM was repeated in 72 % of the infants and 24% were discharged. Discussion: The EchoTM scheduled before discharge or during the first month, in NB with asymptomatic murmur, allows us to make an early diagnosis of heart disease. The possibility of doing an emergency EchoTM allows a rapid and accurate diagnosis, identifying NB with critical heart disease requiring immediate intervention and transfer to a terti­ary center. The EchoTM between these two hospitals of different level, brought benefits to the health care provided, avoiding discomfort to patients and allowing an adequate referral to pediatric cardiol­ogy when needed.

Keywords : Echocardiography; telemedicine; congenital heart desease; newborn infant.

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