Ejection clicks are always considered abnormal after how many hours of life?

Ejection clicks refer to high-pitched sounds associated with the rapid movement of blood through the heart's outflow tracts, often noted during the neonatal period. In neonates, the presence of ejection clicks during the first few hours of life can be normal due to transient hemodynamic adjustments. However, if ejection clicks are still present after 24 hours of life, they typically indicate an underlying pathological process, such as structural heart defects or other cardiac abnormalities.

This diagnosis stems from the physiological understanding that after the initial adaptation period following birth, persistent abnormal heart sounds can signal problems that need further evaluation. Thus, recognizing that ejection clicks occurring after 24 hours of life require a more thorough cardiac assessment is crucial in providing safe and effective care for neonates.