Spectrum of structural heart disease among adolescents in a tertiary health facility in Enugu, South East Nigeria.

Background: Structural cardiac anomalies are neglected area of research among adolescents. Objectives: The objective of this study was to determine the pattern of presentation and clinical manifestations of structural cardiac diseases among adolescents attending UNTH, Enugu, Nigeria. Methods: An analysis of structural heart defects (congenital and acquired) seen among adolescents attending both the children outpatient clinic and cardiology clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu was undertaken over a five-year period. Results: A total of 778 echocardiography was done among children from day 1 to 24 years. Of these, 51 adolescents had echo confirmed structural heart disease. Forty-two (42/51) 82.4% had congenital heart disease. Their age ranged between 120 and 242 months with a mean age of presentation as 168 (36.5) months. The overall prevalence rates of structural heart diseases among these adolescents was (51/14,849) 0.34%; while that for congenital was (42/14849) 0.28% and that for acquired was (9/14849) 0.06%. The commonest congenital heart disease observed in these adolescents was ventricular septal defect (16/51) 31.4%, and Tetralogy of Fallot (TOF) (12/51) 23.5%, followed by AV canal defect (6/51) 11.8%. The commonest acquired heart disease is Rheumatic Heart Disease (RHD), and observed in 9.8% followed by cardiomyopathy seen in 7.8% of cases. Among those with congenital heart disease, surgery was performed in 31.8% of the subjects. However, following surgery, 78.6% (11/14) still has residual heart defect. Conclusions: The results of this study show that 0.34% per cent of adolescents who attended UNTH in Enugu State had cardiac abnormalities. The prevalence of congenital and acquired heart diseases was 0.28% and 0.06% respectively. The commonest forms seen were those with VSD and RHD.