Selective criteria for differential diagnosis of infants with symptoms of congenital heart disease

Abstract

147 case records of infants referred to the Brompton Hospital in the first year of life with a provisional diagnosis of congenital heart disease were examined. Statistical analyses were performed to evaluate selective criteria for the allocation of these infants into a group with lung disease, or into 1 of 5 major haemodynamic groups - namely, acyanotic, complete transposition of the great arteries, pulmonary outflow tract obstruction, common mixing situations, or hypoplastic left heart syndrome. Arterial PO2 in high oxygen concentration, cardiothoracic ratio, and pulmonary vascular markings on the admission chest x-ray; respiratory rate; P-wave morphology, the electrical sign of the T-wave in lead V4R, and the presence or absence of Q-waves in leads V4R and V6 on the electrocardiogram were significant. A decision tree for the differential diagnosis of infants with suspected congenital heart disease into 5 haemodynamic groups and a group with lung disease is presented, and its predictive value is assessed.