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Volume 12
Issue 3
10.3390/children12030366
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Review

Missed or Delayed Diagnosis of Heart Disease by the General Pediatrician

by
Ageliki A. Karatza
1,
Sotirios Fouzas
1,
Despoina Gkentzi
1,
Eirini Kostopoulou
1,
Christina Loukopoulou
1,
Gabriel Dimitriou
1 and
Xenophon Sinopidis
2,*
1
Department of Pediatrics, University Hospital, School of Medicine, University of Patras, 26504 Patras, Greece
2
Department of Pediatric Surgery, University Hospital, School of Medicine, University of Patras, 26504 Patras, Greece
*
Author to whom correspondence should be addressed.
Children 2025, 12(3), 366; https://doi.org/10.3390/children12030366
Submission received: 28 December 2024 / Revised: 12 March 2025 / Accepted: 13 March 2025 / Published: 15 March 2025
(This article belongs to the Section Pediatric Cardiology)
Versions Notes

Abstract

Missed or delayed heart disease diagnoses pose a major challenge in pediatric primary care. Many cardiac conditions present with subtle or nonspecific symptoms that resemble benign childhood illnesses, making their prompt recognition difficult. This review describes congenital and acquired heart diseases prone to diagnostic delays, including critical congenital heart disease, coarctation of the aorta, atrial and ventricular septal defects, myocarditis, Kawasaki disease, heart failure, and pulmonary arterial hypertension. The atypical presentations of these disorders and the associated diagnostic pitfalls are emphasized. Furthermore, the importance of alarming symptoms and signs, such as chest pain, palpitations, syncope, and abnormal heart murmurs, is underscored. A structured approach to these red flags is presented to assist primary care pediatricians in identifying children at risk, initiating appropriate management, and referring them for specialized evaluation. The importance of preparticipation screening for athletes is also discussed, highlighting how it can be applied to all children during routine health visits to identify those with heart disease. Appropriate training is essential to increase pediatricians’ ability to recognize and manage cardiac patients.
Keywords: heart disease; diagnosis; congenital heart disease heart disease; diagnosis; congenital heart disease

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MDPI and ACS Style

Karatza, A.A.; Fouzas, S.; Gkentzi, D.; Kostopoulou, E.; Loukopoulou, C.; Dimitriou, G.; Sinopidis, X. Missed or Delayed Diagnosis of Heart Disease by the General Pediatrician. Children 2025, 12, 366. https://doi.org/10.3390/children12030366

AMA Style

Karatza AA, Fouzas S, Gkentzi D, Kostopoulou E, Loukopoulou C, Dimitriou G, Sinopidis X. Missed or Delayed Diagnosis of Heart Disease by the General Pediatrician. Children. 2025; 12(3):366. https://doi.org/10.3390/children12030366

Chicago/Turabian Style

Karatza, Ageliki A., Sotirios Fouzas, Despoina Gkentzi, Eirini Kostopoulou, Christina Loukopoulou, Gabriel Dimitriou, and Xenophon Sinopidis. 2025. "Missed or Delayed Diagnosis of Heart Disease by the General Pediatrician" Children 12, no. 3: 366. https://doi.org/10.3390/children12030366

APA Style

Karatza, A. A., Fouzas, S., Gkentzi, D., Kostopoulou, E., Loukopoulou, C., Dimitriou, G., & Sinopidis, X. (2025). Missed or Delayed Diagnosis of Heart Disease by the General Pediatrician. Children, 12(3), 366. https://doi.org/10.3390/children12030366

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