Prospective study of congenital heart disease in children.

Abstract

OBJECTIVE: Descriptive analysis of patients with congenital heart disease. DESIGN: Prospective study. SETTING: Professorial Paediatric Unit, Lady Ridgeway Hospital, Colombo 8. METHOD: All patients with congenital heart disease (CHD) admitted to the Professorial Paediatric Unit at Lady Ridgeway Hospital from August 1998 to August 1999 were included in this study. Data were collected using a pretested questionnaire which was filled by one of the authors. Patients were followed up to date. RESULTS: 102 patients, 53 (52.0%) males with congenital heart disease were studied. All patients were evaluated with chest xray, ECG and 2 D echocardiography, except for two. Based on clinical and echocardiographic findings 69 (67.6%) were found to have acyanotic and 33 (32.4%) cyanotic heart disease; 22 (21.5%) had a ventricular septal defect. Tetralogy of Fallot was diagnosed in 10 (9.8%) patients and was the commonest cyanotic CHD. 52 (51.0%) cases were detected between the ages of 2 weeks to 12 months, and 39 (38.2%) were detected routinely at the postnatal examination of the newborn. Only 12 (11.7%) patients underwent corrective surgery, 10 in Sri Lanka, and 2 in India. 19 children died during the study period, a case fatality of 18.6%. CONCLUSIONS: Previous studies have shown that congenital heart disease accounted for between 16% to 30% of deaths in the Professorial Paediatric Unit at LRH. This is the second commonest cause of deaths in the unit. This study has revealed a high case fatality rate among the patients awaiting corrective surgery. Unless surgical care for patients with congenital heart disease in the public sector are improved, many such children will continue to die early due to lack of facilities.