CARDIAC DISEASE IN CHILDREN

Abstract

Evaluation of patients newly referred to a pediatric cardiology clinic revealed that approximately twothirds of the children did not have heart disease. Of the other third, those with significant heart disease, 77% had congenital malformations and most were in the first year of life when diagnosed. Those in the first month of life had the highest mortality rate. Among newly referred school-aged children rheumatic heart disease was the major diagnosis. Screening constituted a high proportion of the service's work load. Pediatricians did not differ significantly from other referral sources in the preselection for referral of cardiac cases. The annual incidence of pediatric heart disease was comparable for different geographic areas surrounding the medical center and for racial groups. However, significant differences were found in the circumstances leading to referral. In disadvantaged black children, referral depended principally on hospital clinics visited for noncardiac illness. White children were predominantly referred in the course of routine examinations performed by pediatricians. The findings reveal a need to plan specialty services in relation to the population base and with consideration of the accessibility and performance of the professionals who will select the patients for referral.