Spectrum of Congenital Heart Diseases in Children (<5 Years) in a Tertiary Care Centre

Abstract

Background: Congenital heart disease (CHD) is the most common congenital malformation and an important cause of morbidity and mortality among children. Early diagnosis and timely intervention can significantly improve outcomes. Knowledge of the spectrum of CHD in a particular geographical region helps in planning healthcare resources and early referral services.

Objectives: To study the spectrum, demographic characteristics, clinical presentation, and echocardiographic profile of congenital heart diseases among children below five years of age attending a tertiary care centre.

Materials and Methods: A hospital-based prospective observational study was conducted in the Department of Pediatrics of a tertiary care teaching hospital over a period of 18 months. Children aged less than 5 years with clinically suspected CHD and confirmed by two-dimensional echocardiography were included. Demographic details, presenting symptoms, physical findings, and echocardiographic diagnoses were recorded and analyzed.

Results: A total of 150 children with confirmed CHD were enrolled. The majority were infants (58.0%). Males constituted 56.0% of cases. Acyanotic CHDs accounted for 81.3% while cyanotic CHDs accounted for 18.7%. Ventricular septal defect (VSD) was the most common lesion (34.0%) followed by atrial septal defect (ASD) (22.0%), patent ductus arteriosus (PDA) (12.7%), atrioventricular septal defect (AVSD) (6.0%), and pulmonary stenosis (5.3%). Tetralogy of Fallot (TOF) was the most common cyanotic CHD (8.7%). Breathlessness (68.7%), recurrent respiratory infections (54.0%), feeding difficulty (48.7%), and failure to thrive (42.0%) were the common presenting complaints.

Conclusion: Acyanotic congenital heart diseases predominate in children under five years. VSD remains the most common congenital cardiac lesion, while TOF is the most frequent cyanotic defect. Early echocardiographic screening in symptomatic infants facilitates timely diagnosis and management.