Publication: Incidence of congenital heart disease in tertiary care hospital
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Date
2008
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Abstract
Aims and Objectives: The present study was under taken to determine the spectrum, clinical profile and outcome of
patients with congenital heart disease (CHD) admitted to a tertiary care hospital.
Materials and methods: This is a retrospective, observational hospital based study conducted during January 2006
to December 2006. Out of 14461 admissions, 84 were cases of CHD. Only patients with echocardiographic proof of
CHD were included in the study. Detailed clinical and laboratory findings and outcome of all cases were noted in
pre-structured formats. Data were entered in MS-excel. Data was analyzed by software SPSS version 10.
Results: The incidence of CHD was 5.8 per 1000 hospitalized patients. Out of 84 CHD cases, 51 were males and 33
females; with a male to female ratio of 1.5:1. CHD presented more frequently during infancy (46 %). Acyanotic
heart disease was detected in 58 (69 %) cases while cyanotic heart disease was detected in 26 (31%) cases. Among
acyanotic heart disease, ventricular septal defect (VSD) was found in 49 (58.3%), atrial septal defect (ASD) in 4
patients (4.8%), endocardial cushion defect (ECD) in 2 patients (2.4%) and dextrocardia was found in 3 patients
(3.6%). Among cyanotic heart disease, Tetralogy of Fallot (TOF) accounted for 13.1%, total anomalous pulmonary
venous connection (TAPVC) 3.6%, transposition of great arteries (TGA) with VSD 1.2% and unspecified cases of
heart disease was found in 13.1%. VSD and TOF were the most common lesions while other CHD like ASD,
dextrocardia, TAPVC, ECD, TGA with VSD were encountered less frequently. The most common clinical
presentations were failure to thrive (FTT) and developmental delay (86.9%), breathlessness (69%), lower respiratory
tract infection (LRTI) (52%), congestive cardiac failure (CCF) (46%), cyanosis (20.2%), cyanotic spell (9.5%) and
infective endocarditis (9.5%). The mortality rate was 20 %.
Conclusion: The incidence of CHD was 5.8 per thousand hospitalized children. VSD, TOF were the most common
congenital cardiac lesion. VSD was observed either isolated or associated with other lesions like TGA. The
mortality rate was 20 %. The mortality usually occurred in those patients complicated with congestive cardiac
failure, lower respiratory tract infection and infective endocarditis.
Key words: congenital heart disease, epidemiology, ventricular septal defect, Tetralogy of Fallot.
Description
Shah GS1, Singh MK2, Pandey TR3, Kalakheti BK4, Bhandari GP5
1,4Assistant Professor, Department of Pediatrics and Adolescent Medicine, BPKIHS, Dharan, 2Senior Resident, Department of Pediatrics and Adolescent Medicine, BPKIHS, Dharan, 3Student, MBBS, BPKIHS, Dharan, 5Senior Resident, Department of Community Medicine, BPKIHS, Dharan