Unrepaired congenital heart diseases in adults – Detection rate and diagnostic errors

Abstract

Context: There are very few data about the unrepaired congenital heart disease (CHD) in adults. There are high chances of errors in diagnosis of CHD in adult population due to various reasons. If proper diagnosis is made, many of these CHDs are amenable to surgery leading to improved quality of life. Aims: Primary objective of the study was to know the detection rate of unrepaired CHD in adults. We have also reported common errors done while making the diagnosis of CHD in adults. Subjects and Methods: This was a retrospective observational study conducted from March 2020 to September 2021. Patients more than 18 years old who came for transthoracic echocardiogram (TTE) for any reason were included, and the detection rate of unrepaired CHD was calculated. Simultaneously, we have also checked for any errors in reports done outside our center and classified them based on their effect on management. Results: During the study period, 6675 TTEs were done in the study population, out of which 89 (1.33%) were detected with unrepaired CHD. Acyanotic CHD was detected in 81 (91%), whereas the rest 8 (9%) had cyanotic CHD. Forty-one patients had echocardiography report done outside, out of which 25 (61%) had discrepancies. Discrepancies were more in complex CHD. Conclusions: Cardiologists or echocardiographers should follow systematic approach and place special emphasis on identifying congenital heart diseases. Many potential lesions are amenable to surgery and near-complete correction leading to improved duration and quality of life.