Iranian Heart Journal

Iranian Heart Journal

Heart Murmurs Detected During Newborn Examination: A Case Report Highlighting the Need for Caution

Document Type : Case Report

Authors
Toktam Sheykhian 1
Amir Amiri 1
Kiara Rezaei-Kalantari 2
Vafa Ghorbansabagh 1
1 Maternal, Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran.
2 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
Abstract
In this case report, we examine a 2-day-old infant referred for evaluation due to the detection of a heart murmur. Coronary artery fistula, an anomalous connection between coronary arteries and a cardiac chamber or vascular structure bypassing the typical capillary network, is the focus of our discussion. The newborn displayed no symptoms, and all other physical assessments appeared normal. Transthoracic echocardiography uncovered an enlargement of the coronary arteries, notably the proximal right coronary artery. Furthermore, a color Doppler scan indicated turbulent flow at the terminal portion of the ventricular septum, revealing a fistula linking the right coronary artery to the right ventricle. Throughout a 1-year follow-up period, the fistula spontaneously closed, resulting in the resolution of the heart murmur. Remarkably, the diameters of the coronary arteries reverted to the standard range. It is noteworthy that while surgical or interventional methods are sometimes used to treat these patients, spontaneous closure may occur in asymptomatic cases with close monitoring over time. (Iranian Heart Journal 2025; 26(1): 107-112)
Keywords
Neonate
Congenital coronary fistula
Murmur
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Iranian Heart Journal
Volume 26, Issue 1
Winter 2025
Pages 107-112