spectrum of congenital heart diseases in meghalaya –a hospital based study
Post on 10-Jan-2016
19 Views
Preview:
DESCRIPTION
TRANSCRIPT
Spectrum of congenital heart diseases in Meghalaya –A Hospital
based studySourabh Gohain Duwarah*. Dhrubajyoti Sharma*,
Rashna Dass**, Ajit Chhetri**, Pankaj Jain*, Bhaskar Saikia*, Himesh Barman*,
(*Senior Resident, **Assistant Professor)
Department of Pediatric Disciplines, North Eastern Indira Gandhi Regional Institute of Health and Medical
Science (NEIGRIHMS), Shillong.
Introduction • Congenital heart disease (CHD) refers to
structural or functional heart disease that is present at birth even if it is discovered much later
• CHD: Occurs in approximately 8/1000 live births.
• No available data on prevalence of CHD from Meghalaya
Aims and objectives
• The present study was conducted to ascertain the spectrum of Congenital heart disease in Meghalaya (0 to 18 years old).
Material and methods
• Study design: Retrospective study from Jan’05 to June’07 (2.5 years).
• Place of study: Dept. of Pediatric Disciplines,NEIGRIHMS,Shillong.
• Age group: 0 to 18 years of age.
• Data on congenital heart diseases were collected in semi structured proforma and analysed.
• The source of information was all outpatient and inpatient records including echocardiography records from Jan’05 to June’07
• Exclusion criteria included CHDs with associated syndromes, since the present study was to know the prevalence of isolated CHDs in Meghalaya.
Results and observations
• Total no of cases seen during study period:
12,322.
• Congenital heart disease: 286(2.32%).
2.32% Total no ofcases seenduring studyperiod
Cases of CHD
Results- No. of referred cases
Thirty two percent(32%)cases were referred cases.
Pie diagram showing percentage of the referred cases
68%
32%
referred cases
not referred cases
Results- Distribution of cases during the study period
Distribution of cases during the study period
91(31.81)
69(24.12)
52(18.18)
46(16.08)
28(9.79)
0102030405060708090
100
Jan-June'05
July-Dec'05
Jan-June'06
July-Dec'06
Jan-June'07
Cases increased from 9.79% in Jan-June’05 to 31.81%
in Jan-June’07.
Results- age wise distribution
4.196.99
9.0910.48
26.92
13.28
1.39
4.89
0
5
10
15
20
25
301st
yr
2nd y
r
3rd
yr
4th
yr
5th
yr
6th
yr
7th
yr
8th
yr
9th
yr
10th
yr
11th
yr
12th
yr
13th
yr
14th
yr
15th
yr
16th
yr
17th
yr
18th
yr
Maximum cases were diagnosed during infancy(26.92%) followed by second year(13.28%) of life.
Results – various CHDs observed in the present study
Congenital heart disease (CHD)
Total no of cases Percentage(%)
Ventricular septal defect (VSD)
136 47.55
Atrial septal defect (ASD)
67 23.52
Patent ductus arteriosus (PDA)
37 12.93
Tetralogy of fallot (TOF)
23 8.04
Pulmonary stenosis (PS)
7 2.44
Endocardial cushion defect (ECD)
4 1.39
Results-various CHDs observed in the present study
CHD Total no of cases
Percent(%)
Aortic stenosis (AS) 3 1.04
Bicuspid aortic valve (BAV) 2 0.6
Complex CHD (cyanotic) 2 0.6
Coarctaion of aorta (CoA) 1 0.35
Double outlet right ventricle (DORV)
1 0.35
Transposition of great arteries (TGA)
1 0.35
PDA with AS 1 0.35
Tricuspid atresia (TA) 1 0.35
Results- sex wise prevalence of CHD
54%
46%Male
Female
The present study shows that, 131(46%) male and
155(54%) female children had CHD.
Results– sex wise distribution
63
29
13 13
73
38
24
3532
10
4 40
20
10
20
30
40
50
60
70
80
VSD ASD PDA TOF PS ECD AS others
Male
Female
VSD ASD PDA TOF PS ECD AS Others
Male 63(46.32) 29(43.28) 13(35.13) 13(56.52) 3(42.85) 2(50) 3(100) 5(3.81)
Female 73(53.67) 38(56.71) 24(64.86) 10(43.47) 4(57.14) 2(50) 0 4(2.58)
Results-prevalence of acyanotic CHD
Among the acyanotic CHDs most common was VSD(53%)
followed by ASD(26%) and PDA(14%).
Results- prevalence of cyanotic CHD
Among the cyanotic group most common was TOF(81%).
Prevalence of major types CHDs in the available literature & its
comparison to the present studyPlace VSD(%) ASD(%) PDA(%) TOF(%)
Present study 47.5 23.5 12.9 8
India (1971) 29 12 11 17
UK (1981) 32.5 5.9 11.9 5.9
USA (1990) 32.1 7.4 8.3 3.8
Japan (1990) 60 5.3 3.6 5.8
Egypt (2000) 35.3 13.6 6.1 5
S.Arabia (2001) 39.5 11.5 8.6 4.2
Comparision of prevalence of CHD in the present study with studies in south
India and Punjab.
Analysis revealed a prevalence of CHD 2.32% which was not as high as other parts of the country.
2.32%2.50%
3%
0.00%
0.50%
1.00%
1.50%
2.00%
2.50%
3.00%
3.50%
Present study South India Punjab
Name of the CHD
Present study (n=286)
(Jan’05-June’07)
Study by Smitha R et al in mysore (n=500)
(2000-2004)
Study by L.Kasturi et al in Mumbai (n=108)
VSD 136(47.55) 242(40.47) 29(27)
ASD 67(23.52) 114(19.06) 26(24)
PDA 37(12.93) 57(9.53) 7(6)
TOF 23(8.04) 80(13.38) 10(9)
Comparison of the prevalence of major CHDs in different studies in
India.
Discussion contd…
• The frequency of rare types of CHDs like AS,PS, TGA,TA,ECD were less in the present study.
• Most of the CHDs were diagnosed during infancy(26.92%) which was in accordance with the other studies.
• Prevalence was slightly higher in females as compared to the males.
Discussion contd…
• The prevalence of CHDs in the study was
increasing from 2005 to 2007 (9.79% in Jan-
June’05 to 31.81% in Jan-June’07).
• Increasing number of OPD visits,
improvement of diagnosis, attention or
awareness among the referring
government / private sector doctors might be
the causes for the increase.
ConclusionThe present findings indicate that,
(a) Prevalence of CHDs in Meghalaya is not as high as the
prevalence reported by other Indian studies.
(b) However, it is an important disease which requires
immediate attention and highlights the need for
appropriate cardio-thoracic surgical services
accessible to the common man in this region .
Thank you…
Thank youThank you
top related