Pattern of congenital heart diseases in a tertiary care teachinghospital, Chinna Kakani, Guntur

Objective: To evaluate the spectrum and pattern of congenital heart diseases in NRI general hospital, a tertiary care teaching hospital, Chinna Kakani, Andhra Pradesh. Methods: A retrospective hospital based analysis of children attending pediatric department over a period of two years during January, 2014 to December, 2015 was performed. Patients suspected to have cardiac symptoms or cardiac murmurs were referred for 2D echo and colour Doppler to confirm the diagnosis. Prevalence rate per 1000 patients was calculated. Relative frequencies of individual CHD types as a proportion of total CHDs were also calculated. Results: A total of 174 Echo confirmed cases of CHDs were identified from a total of 60,000 patients attending the hospital over a two year period with a calculated prevalence of 2.9/1000 patients. Of total cases 96 were female and 78 were male children. A total of 149 Acyanotic CHD cases (86.5%) were identified of which, Isolated ASD were 52 (35%), Isolated VSD were 42(28%), AVCD were 2 (1.34%), PS were 12(8%),AS were 4(2.7%), COA were 2(1.34%), PDA were22(14.7%), combination of ASD + VSD were 10(6.7%)  and Dextrocardia with situs inversus were 3(2%). A total of 25 cases of Cyanotic CHD were identified, of which TOF and its variants were 16(64%), DORV+VSD+PS were 2(8%), rare complex CHDs like DORV+HLHS, TAPVC, Ebstien Anomaly, Cortriatrium, were one case(4%) each and TGA were 3(12%) cases. Conclusion: The calculated prevalence of CHD at 2.9 /1000 among hospital attending patients could be an underestimation of actual disease burden in our community. The maximum numbers of children with CHD were identified by 5 years of age. The most commonly found Acyanotic CHDs were ASD, VSD and PDA. The most common cyanotic CHD was TOF.