Profile and Clinical Spectrum of Congenital Heart Defects in NICU
Introduction: Congenital heart defects are commonest birth defects and is an important cause of mortality and morbidity in newborns. The current study was done aiming at determining profile and clinical spectrum of various congenital heart diseases (CHD) in neonatal period.
Methodology: An observational study was carried out in the NICU, Department of Pediatrics, Jawaharlal Nehru Medical College, Aligarh from Feb 2014 to Aug 2015 with the objective to determine profile of various congenital heart defects. All patients with clinical suspicion of congenital heart defect were further evaluated with echocardiography. Patients who were preterm having PDA and PFO were excluded from cases. Prevalence of various congenital heart defects was calculated. Clinical Spectrum of various congenital heart defects was observed.
Observations: Total newborns screened 238 and 52 congenital hearts defect were detected. Acyanotic heart defect contributed 67% while cyanotic heart defect contributed 23%. VSD was the most common lesion while TOF (11.5%) was commonest among cyanotic heart defects. Most of the cyanotic heart defects were detected on screening as murmur on auscultation while PDA of bigger size presented as fast breathing. In cyanotic heart, defect classical TOF presented with only murmur while TOF with PA presented as cyanosis.
Conclusion: VSD was the most common congenital heart defect detected while Tetralogy of Fallot was commonest among the cyanotic heart defects.
2. Dolk H, Loane M, Garne E. For the European Surveillance of Congenital Anomalies (EUROCAT) working Group. Congenital heart defects in Europe: Prevalence and perinatal mortality, 2000-2005. Circulation 2011;123:841-9.
Samanek M, Voriskova M. Congenital heart disease among 815,569 children born between 1980 and 1990 and their 15 year survival: a prospective Bohemia
survival study. PediatrCardiol1999;20:411-17.
4. Wren C, Richmond S, Donaldson L. Presentation of congenital heart disease in infancy: implications for routine examination. Arch Dis Child Fetal Neonatal Ed.
5. Wren C, Richmond S, Donaldson L. Temporal variability in birth prevalence of cardiovascular malformations. Heart 2000;83:414-19.
6. Sadiq M, Stümper O, Wright JG, et al. Influence of ethnic origin on the pattern of congenital heart defects in the first year of life. Br Heart J 1995;73:173-6.
7. Khalil A, Aggarwal R, Thirupuram S, Arora R. Incidence of congenital heart disease among hospital live births in India. Indian Pediatr 1994; 31: 519-24.
8. Lawn JE, Cousens S, Zupan J.4 million neonatal deaths: When? Where? Why? Lancet 2005; 365:891- 900.
9. Saxena A. Congenital Heart Disease in India: A status Report. Ind. Jrnl. Paed.Vol. 72, July 2005.595-8.
10. Kinare SG, Sharma S. Congenital Heart Disease in 1st year of life (an autopsy study of 270 cases). Ind. Jrnl. Paed 1981:48:745-754.
11.Islam MN, Hossain MA, Khaleque MA, Das MK, Khan MRH, Bari MS, Bhuiyan MKJ. Prevalence of Congenital Heart Disease in Neonate in a Tertiary Level Hospital. Nepal Journal of Medical sciences 2013;2(2):91-5.
12.Hussain S, Sabir MU, Afzal M, Asghar I.Incidence of congenital heart disease among neonates in a neonatal unit of a tertiary care hospital.J Pak Med Assoc. 2014 Feb;64(2):175-8.