Ann. Pak. Inst. Med. Sci. 2010; 6(2): 120-123

Background: Patients with congenital heart disease frequently visit pediatrics ward usually with other associated problems.
Objective: To find out frequency, various presentations of cardiac defects and short term outcome
Study Design: Descriptive study
Place and duration of study: Department of Pediatrics Benazir Bhutto Hospital Rawalpindi August 2009-July 2010.
Results: A total of 96 patients, aged 0 to 156 months, had confirmed congenital cardiac defects. Male were 64. Three fourth patients presented under 1 year of age. 58.3% had acyanotic and 41.7% had cyanotic congenital heart disease, with ventricular septal defect (VSD-33.3%) and Tetralogy of fallot (TOF-17.7%) commonest among the list. Commonest symptoms were respiratory distress (74%) and fever (66.7%). Mean hospital stay was 6 + 3 days, 68 (70.8%) admitted patients were discharged, 21 (21.9%) expired while 7 patients (7.3%) left against medical advice.
Conclusion: CHD mostly presented in infancy. VSD and TOF were the commonest congenital cardiac defects.
KEY WORDS: Congenital Heart disease (CHD), presentation


Introduction

CHD is defined as a “gross structural abnormality of heart or intrathoracic great vessels that is actually or potentially of functional significance.¹ It is one of the most common structural congenital malformations and comprises upto 25% of all congenital anomalies. It contributes significantly in infant morbidity and mortality.²
Its incidence is reported upto 8/1000 live birth.3 Asian race is found to be more affected than non Asian race due to high rate of consanguineous marriages.⁴ A study done at Aga Khan University hospital by Hassan showed prevalence rate of CHD upto 4/1000 live births in Karachi.⁵ Same as that reported in India6. Cardiac defects are grossly divided into acyanotic and cyanotic heart diseases, former being more common. VSD (30%-35%) and TOF (5-7%) are commonest among acyanotic and cyanotic congenital heart diseases respectively.⁷
Incidence of CHD is underestimated due to home deliveries and early discharge of mothers along with their neonates from hospitals without proper neonatal examination pertinent to cardiovascular system by a qualified and experienced personal.¹⁰ About half of the neonates with murmurs in early days of life have structural cardiac lesions8. Cardiac examination at six weeks of age will detect about 2/3rd of the asymptomatic cases.²⁹ CHD has wide spectrum of severity in infants: about 2-3 infants /1000 live births will develop symptoms related to cardiac defects during first year of life.⁷ CHD is two and a half times more common in school going children as compared to acquired heart disease⁹. These children are detected upon referral to echocardiography due to cyanosis, clubbing, presence of cardiac murmur.
They might get admissions in pediatric ward due to repeated chest infections, heart failure and complications of underlying defect.¹⁰ Therefore number of congenital heart disease patients is increasing due to new entries and their enhanced survival due to better facilities of diagnosis and management.
The purpose of this study is to find out frequency and various presentations of cardiac defects in pediatric patients presenting to pediatric department Benazir Bhutto Hospital (BBH) Rawalpindi.