Congenital heart diseases: Pattern of clinical presentations in children less than 2-years of age in a pediatric practice in south- south Nigeria

Abstract

The increase in the prevalence of congenital heart disease remains a major contributing factor to childhood morbidity and mortality in Africa. The study describes the clinical features of children with CHD that presented to a general pediatric hospital, to improve on early recognition and management of the diseases. The prevalence of CHD from the study was 2 per 100 (30 per 1577 or 1 in 52) i.e. (2/100 or 20/1000). A higher incidence in females (53.3%) with  M: F = 1:1.14, the majority presented with difficulty / fast breathing (70%), cough(40%), other presenting symptoms are poor weight gain (26.7%), delayed milestones(13.3%). On examination, 60% had dyspnea, 56.7% had murmur. Packed cell volume for acyanotic heart disease ranged 28-30%, and 50-61% for cyanotic heart disease. The majority had comorbid bronchopneumonia (46.6%), and heart failure (23.3%). Echocardiographic findings revealed VSD in 26.7%, 20.0% had PDA and tetralogy of Fallot in 6.7%, Transposition of Great Arteries in 3.3%, and Dextrocardia in 3.3%. The outcome showed that 30% had no symptoms on follow-up, 23.3% were referred for surgery, 10% dropped from follow-up and 3.3% died. These findings which are comparable to the findings of other researchers showed that congenital heart disease has a place in childhood morbidity and mortality, therefore appropriate attention should be directed to improve on early recognition and management of the diseases.