Presentation on theme: "(*Senior Resident, **Assistant Professor)"— Presentation transcript:
1(*Senior Resident, **Assistant Professor) 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.
2IntroductionCongenital heart disease (CHD) refers to structural or functional heart disease that is present at birth even if it is discovered much laterCHD: Occurs in approximately 8/1000 live births.No available data on prevalence of CHD from Meghalaya
3Aims and objectivesThe present study was conducted to ascertain the spectrum of Congenital heart disease in Meghalaya (0 to 18 years old).
4Material and methodsStudy 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’07Exclusion criteria included CHDs with associated syndromes, since the present study was to know the prevalence of isolated CHDs in Meghalaya.
5Results and observations Total no of cases seen during study period:12,322.Congenital heart disease: 286(2.32%).
6Results- No. of referred cases Thirty two percent(32%)cases were referred cases.
7Results- Distribution of cases during the study period Cases increased from 9.79% in Jan-June’05 to 31.81%in Jan-June’07.
8Results- age wise distribution Maximum cases were diagnosed during infancy(26.92%) followed by second year(13.28%) of life.
9Results – various CHDs observed in the present study 1(0.35)1(100)TAResults – various CHDs observed in the present studyCongenital heart disease (CHD)Total no of casesPercentage(%)Ventricular septal defect (VSD)13647.55Atrial septal defect (ASD)6723.52Patent ductus arteriosus (PDA)3712.93Tetralogy of fallot (TOF)238.04Pulmonary stenosis (PS)72.44Endocardial cushion defect (ECD)41.39
10Results-various CHDs observed in the present study Total no of casesPercent(%)Aortic stenosis (AS)31.04Bicuspid aortic valve (BAV)20.6Complex CHD (cyanotic)Coarctaion of aorta (CoA)10.35Double outlet right ventricle (DORV)Transposition of great arteries (TGA)PDA with ASTricuspid atresia (TA)
11Results- sex wise prevalence of CHD The present study shows that, 131(46%) male and155(54%) female children had CHD.
12Results– sex wise distribution VSDASDPDATOFPSECDASOthersMale63(46.32)29(43.28)13(35.13)13(56.52)3(42.85)2(50)3(100)5(3.81)Female73(53.67)38(56.71)24(64.86)10(43.47)4(57.14)4(2.58)
13Results-prevalence of acyanotic CHD Among the acyanotic CHDs most common was VSD(53%)followed by ASD(26%) and PDA(14%).
14Results- prevalence of cyanotic CHD Among the cyanotic group most common was TOF(81%).
15Prevalence of major types CHDs in the available literature & its comparison to the present study PlaceVSD(%)ASD(%)PDA(%)TOF(%)Present study47.523.512.98India (1971)29121117UK (1981)32.55.911.9USA (1990)126.96.36.199.8Japan (1990)605.33.65.8Egypt (2000)35.313.66.15S.Arabia (2001)39.5188.8.131.52
16Comparision of prevalence of CHD in the present study with studies in south India and Punjab. 2.32%2.50%3%0.00%0.50%1.00%1.50%2.00%3.00%3.50%Present studySouth IndiaPunjabAnalysis revealed a prevalence of CHD 2.32%.Analysis revealed a prevalence of CHD 2.32% which was not as high asother parts of the country.
17Comparison of the prevalence of major CHDs in different studies in India. Name of the CHDPresent study (n=286)(Jan’05-June’07)Study by Smitha R et al in mysore (n=500)( )Study by L.Kasturi et al in Mumbai (n=108)VSD136(47.55)242(40.47)29(27)ASD67(23.52)114(19.06)26(24)PDA37(12.93)57(9.53)7(6)TOF23(8.04)80(13.38)10(9)
18Discussion 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.
19Discussion 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.
20Conclusion The 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 .