The spectrum of structural heart defects seen in children at the University College Hospital, Ibadan

Abstract

Background: Structural heart defects constitute one of the commonest reasons for Paediatric Cardiology consultations. The availability of echocardiography has obviated the need for invasive procedures in providing an accurate diagnosis and description in such children. Objective: To describe the pattern of congenital and acquired heart diseases seen in children referred to the Paediatric Cardiology Clinic of the University College Hospital, Ibadan Methods: Consecutive cases referred to the Paediatric Cardiology Clinic over a twelve-month period were evaluated by clinical examination, chest x-ray, electrocardiography and echocardiography. Data were analysed using SPSS for Windows software, version 20.0. Frequency distributions were generated and the Wilcoxon signed rank test was used to test the association between the age at onset of symptoms and the age at presentation. Level of significance was set at P < 0.05 Results: Two hundred and forty children underwent echocardiography; 80.4% were aged 5 years and below. Structural heart defects were encountered in 210 (87.5%) children. Congenital defects comprised 80% of the cases, the commonest being VSD, occurring either singly (24.1%) or in combination with other defects in 18.7%. The commonest cyanotic lesion, Fallot′s Tetralogy (9.2%) occurred more commonly than other isolated acyanotic lesions. Acquired heart disease accounted for 7.5% of cases, dilated cardiomyopathy, rheumatic heart disease, and pericardial effusion (occurring in 2.9%, 2.5% and 2.1% respectively). The median age at presentation (13 months) was significantly higher than that at onset of symptoms (11 months) (P = <0.001). Conclusions: Ventricular septal defect remains the commonest structural defect seen in our centre. Fallot′s Tetralogy however is more common than isolated patent ductus arteriosus or atrial septal defect. Dilated cardiomyopathy and RHD are equally common.