Congenital Heart Deffcts in Hirschsprung’s disease: A survey in Iranian population

The aim of this study was to assess the frequency of various forms of congenital heart disease (CHD) among affected children in the Southwestern region of Saudi Arabia. During the study period (July 1994 to June 1996), 608 children were referred to Asir Central Hospital as having CHD. All the children were evaluated by a pediatric cardiologist and had electrocardiogram and echocardiogram. Of the 608 patients, only 335, comprising 162 males and 173 females, had CHD. The male to female ratio was 0.9:1. The frequency of various forms of CHD was as follows: ventricular septal defect (VSD) 32.5%; patent ductus arteriosus 15.8%; atrial septal defect 10.4%; pulmonary stenosis 10.1%; atrioventricular septal defect and mitral valve prolapse, 3.6% each; aortic coarctation/interruption 3.3%; obstructive aortic valve lesions 2.7%; tetralogy of Fallot 4.5%; common ventricle 2.7%; pulmonary atresia (PA) with VSD 1.8%; D-transposition of the great arteries 1.5%; Ebstein anomaly 1.5%; and isolated PA 1.2%. Other lesions were extremely rare. The distribution in this study is similar to that reported in previous studies from other parts of the world, except for the lower incidence of obstructive aortic valve lesions.

Background: Previous studies from high altitudes have reported significantly higher prevalence of congenital heart disease (CHD), consisting almost solely of simple CHD. Little is known about the occurrence of complex CHD. Neonates with complex CHD are likely admitted to NICU. We examined the prevalence and spectrum of complex CHD in NICU in order to depict a truer picture of CHD at high altitude. Methods: We reviewed charts of 4,214 neonates admitted to NICU in Qinghai province (average altitude 3,000 m). Echocardiography was performed in 1,943 babies when CHD was suspected based on clinical examinations. Results: CHD was diagnosed in 1,093 (56.3% of echoed babies). Mild CHD in 96.8% (1058 babies). Moderate CHD in 0.8% (9) included 1 (0.1%) large secundum atrial septal defect, 3 (0.3%) moderate pulmonary stenosis, 2 (0.2%) aortic stenosis and 3 (0.3%) partial anomalous pulmonary venous connection. Severe CHD in 2.4% (26) included 6 (0.5%) complete atrioventricular septal defect, 5 (0.5%) complete transposition of the great arteries, 5 (0.5%) hypoplastic right heart, 3 (0.3%) hypoplastic left heart, 3 (0.3%) double outlet right ventricle, 3 (0.3%) tetralogy of Fallot, 2 (0.2%) truncus arteriosus, 2 (0.2%) total anomalous pulmonary venous connection, 2 (0.2%) severe aortic stenosis, 2 (0.2%) interrupted aortic arch and 2 (0.2%) severe pulmonary stenosis and 1 (0.1%) single-ventricle abnormality. At two-years follow-up in 737 (67.4%) patients, 18 (90%) with severe CHD and 38 (5.3%) with mild and moderate CHD died, and 15 underwent cardiac surgery with 1 early death. Conclusions: At high altitude, a wide spectrum of CHD exists, with many heretofore unreported complex CHD. There is urgent need for routine echocardiography and early interventions in newborns particularly in NICU.

Prevalence, Mortality, and the Disease Burden of Pediatric Congenital Heart Disease in Taiwan

GENETIC PERSPECTIVE OF THE CONGENITAL HEART DISEASE

Objective To investigate the association between Down's syndrome(DS) and congenital heart di-seases(CHD). Methods A total of 575 cases with DS from Jan.1997 to Mar.2013 in Children's Hospital of Chongqing Medical University were recruited.Retrospective study was conducted to analyze the prevalence and types of CHD in DS children, the relationship between the karyotype of DS and the types of CHD, and pulmonary hypertension(PH) and operation treatment. Results There were 370 cases(64.35%, 370/575 cases) with CHD in 575 cases with DS.Among the 370 cases of CHD, 322 cases(87.03%) were septal defects.In which, 57 cases(15.41%) were atrial septal defects, 36 cases(9.72%) were ventricular septal defects, 12 cases(3.24%) were atrioventricular septal defects, and 157 cases(47.30%) were complex septal defects.Forty-eight cases(12.97%, 48/370 cases) were non-septal defect types of CHD(including patent ductus arteriosus, tetralogy of Fallot, double outlet right ventricle, pulmonary atresia, and so on). There was no statistical significance between the karyotype of DS and the types of CHD.There were 246 cases(66.49%, 246/370 cases) with PH.Seventy cases(18.92%, 70/370 cases) had interventional or surgical operations.All of them had descending pulmonary artery pressure after operation.Forty cases had other malformations such as gastrointestinal tract malformation, polydactylism / polydactyly, visual impairment, and so on. Conclusions The most common type of CHD with DS was atrial septal defect, and the second one was ventricular septal defect.There was no relationship between the karyotype of DS and the types of CHD.The patients with CHD in DS were prone to develop PH.So the comprehensive treatment plan should be developed as early as possible. Key words: Down's syndrome; Congenital heart diseases; Pulmonary hypertension

To investigate the prevalence of scoliosis and congenital heart disease (CHD) in the same area and to explore the relationship between them according to a joint school screening. All students aged 6-15 years in 20 schools in Jinghong City, Yunnan Province, China was screened for scoliosis and CHD. Scoliosis screening completed through the Adam's forward bending test with scoliometer measurement, and CHD screening completed through auscultation combined with portable echocardiography (ECHO). The gender, age, distribution of ethnic groups, types of CHD, angle of trunk rotation (ATR) and location of scoliosis were recorded. The severity was divided into 3 grades by ATR. Then the relationship between scoliosis and CHD was analyzed. A total of 17,134 students was screened with a prevalence of suspected scoliosis of 1.7% (298 students), and the prevalence of suspected scoliosis in female was higher than that in male (2.4 vs. 1.2%, P < 0.001), which increased with age (P < 0.01). The prevalence of suspected scoliosis was no different among ethnic groups (P > 0.05). The severity of scoliosis was mainly grade 1 (68.5%), followed by grade 2 (27.2%) and grade 3 (4.4%). And scoliosis was mainly located in lumbar (37.6%). The prevalence of CHD was 3.15‰, and there was no difference in the prevalence of CHD between different gender, age and ethnic groups (P > 0.05). The most common type of CHD was atrial septal defect (27.78%), followed by ventricular septal defect (16.67%). There was only one CHD student in 298 suspected scoliosis students. The prevalence of suspected scoliosis among primary school students was 1.74%, while the prevalence of congenital heart disease was 3.15‰ in Jinghong City, Yunnan Province. And the incidence of CHD in patients with mild suspected scoliosis was low and close to that in normal population.

Neonatal morbidity and mortality are significantly impacted by congenital heart disease (CHD). Echocardiography plays a crucial role in this condition's early diagnosis and management. This research aims to determine the prevalence of CHD diagnosed by echocardiography among neonates admitted to Lady Reading Hospital (LRH), Peshawar. Objective: To identify the rate and variety of CHD in neonates using echocardiography. Methods: A prospective study was conducted in the Department of Pediatrics at LRH Peshawar from January 2023 to January 2024. The study included 100 neonates up to 28 days old with clinical manifestations of CHD. Routine echocardiographic examinations were performed for diagnosis. Descriptive statistics were used to determine the prevalence and type of CHD, while inferential statistics compared means, standard deviations, and p-values. Results: Out of 100 neonates, 72 were diagnosed with CHD. The mean age was 15 days (± 7 days). The most frequently reported defect was ventricular septal defect (VSD), observed in 35% of cases. Atrial septal defects (ASD) were seen in 20% of cases, tetralogy of Fallot (TOF) in 10%, and transposition of the great arteries (TGA) in 8%. The p-value for the prevalence of CHD in males compared to females was 0.03, indicating a significant difference. Conclusion: CHD is relatively frequent in neonates, and neonatal echocardiography is a valuable tool for early diagnosis. Early detection allows for timely management, improving prognosis in affected infants.

This is a longitudinal analysis of the largest and most comprehensive inpatient care database in the United States to determine temporal variation of birth prevalence of congenital heart disease (CHD) diagnosis, adjusting for potentially confounding factors. We compared all entries of CHD diagnoses in the Nationwide Inpatient Sample (NIS) database in 1998 and 2008 to determine differences in birth prevalence of overall CHD and specific CHD phenotypes stratified by race, gender, socioeconomic status, and geographical location. CHD prevalence was 10.2/1000 in 1998 and 10.8/1000 live births in 2008, without significant changes in prevalence (P = .09). Prevalence of isolated patent ductus arteriosus increased from 1.9 to 2.8 per 1000 (P < .001), and this temporal increase remained statistically significant after stratification by race, income status, and geographic location. Prevalence of mild CHD increased from 8.0 to 9.1 per 1000 (P = .01), with most of this increase occurring among Caucasians and the upper socioeconomic class. There was a decrease in prevalence of severe CHD from 1.5 to 0.9 (P = .03), while prevalence of moderate CHD and all other specific CHD phenotypes remained unchanged in both cohorts. We report increased prevalence of isolated patent ductus arteriosus and mild CHD; decreased prevalence of severe CHD; and unchanged prevalence of overall CHD and all other specific CHD phenotype. We speculate that increased prevalence of mild CHD was due to increased case detection because of improvement in echocardiography. Decrease in diagnosis of severe CHD could be due to the impact of pregnancy termination.

BackgroundThe prevalence and risk factors of congenital heart disease among Xinjiang, northwestern part of China is currently unknown.MethodsThis multiple-ethnic, community-based, cross-sectional study was conducted to estimate the prevalence and distribution of congenital heart disease (CHD) in Xinjiang, northwestern part of China. Four major ethnics, Uygur, Han, Kazak, and Hui children in this region were investigated during February 2010 and May 2012.ResultsA total of 14,530 children (0–18 yr) were examined. Of these children, 240 (boys, 43.8%, and girls, 56.3%) were identified with CHD, giving an overall prevalence of 16.5‰ (17.7‰ in Uygur, 6.9‰ in Han, 11.4‰ in Kazak, and 38.1‰ in Hui Chinese, respectively). Ventricular septal defect (VSD, 29.2%), atrial septal defect (ASD, 20.8%), patent ductus arteriosus (PDA, 13.7%), acleistocardia (13.7%), Bicuspid aortic valve (7.9%), pulmonary valve stenosis (5.4%), and tetralogy of fallot (TOF, 4.2%) were common cyanotic and cyanotic defects observed. Compared to non-CHD children, children with CHD had a higher percentage of history of abortion, CHD history of family, consanguinity and premature birth (all P<0.05). In CHD children, 24% of mothers caught a cold, 10% had a febrile illness and 6.7% received antibiotic treatment during the first trimester of pregnancy, that were higher than non-CHD group (all P<0.05).ConclusionThe overall prevalence of CHD in four ethnic children at ages 0–18 yr in Xinjiang was 16.5‰. VSD, ASD and TOF were the most common acyanotic and cyanotic congenital heart defects, respectively. This study also identified some modifiable risk factors that may contribute to the incidence of CHD among the 4 ethnic groups.

Prevalence of Symptomatic Congenital Heart Disease in Tibetan School Children

This study was conducted to determine the prevalence of rheumatic heart disease (RHD) and congenital heart disease (CHD) in primary schoolchildren of Menoufia, Egypt and to study the relationship between these two problems and socioeconomic conditions. A total of 8000 children were screened for cardiac disease in their schools. Children with confirmed RHD and CHD in addition to 200 healthy children (controls) were visited at their homes to assess their social environment and other factors according to a designed questionnaire. We found prevalence rates of 3.4/1000 and 2.6/1000 for the RHD and CHD respectively. The most common cardiac defects were double mitral and pulmonary stenosis in the RHD and CHD groups respectively. Nineteen (39.6%) of the patients were diagnosed for the first time during the study. Penicillin prophylaxis was received by only four (14.8%) of the RHD children and none of the CHD children. The number of other affected siblings, increased multiparity, repeated abortion, and intake of contraceptives by mothers were significantly higher in families of the children with CHD. The proportion of illiterate, unskilled, and heavy smoking fathers was higher in the two patient groups. Family income was lowest in the RHD group, while increased crowding index and low whole social environment were significantly related to both RHD and CHD. Effective programs at the community and health service levels are needed in Menoufia to solve the problem of heart disease in schoolchildren in the immediate future.

To find the prevalence and pattern of congenital heart disease (CHD) at a tertiary care hospital in Uttarakhand, India. A thorough history and clinical examination was done for all the live births and children up to 18 y of age who presented to the institute over a period of 3 y from July 2008 through June 2011. Those suspected of having a CHD, were further evaluated with ECG, chest radiography and the diagnosis was confirmed by color Doppler echocardiography. Of the 36541 children examined, 312 were identified as having congenital heart defects, thus giving a prevalence of 8.54 per 1000 children attending hospital. Only one fifth cases were diagnosed in neonatal period and the diagnosis was delayed beyond infancy in more than half of the cases. Ventricular septal defect (30.45%), atrial septal defect (17.63%), patent ductus arteriosus (9.62%), pulmonary stenosis (6.41%), tetralogy of Fallot (5.45%) and transposition of great arteries (5.13%) were the commonest defects observed. Only 9.29% of children with CHD underwent definitive treatment. The prevalence of CHD at a tertiary referral hospital in Uttarakhand India is 8.54 per 1000 children. VSD and TOF are the most common acyanotic and cyanotic congenital heart defects respectively.

Tetralogy of Fallot: Perioperative Management and Analysis of Outcomes

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. isuog GUIDELINES ISUOG Practice Guidelines (updated): fetal cardiac screening The International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) is a scientific organization that encourages sound clinical practice and high-quality teaching and research related to diagnostic imaging in women's healthcare. The ISUOG Clinical Standards Committee (CSC) has a remit to develop Practice Guidelines and Consensus Statements as educational recommendations that provide healthcare practitioners with a consensus-based approach, from experts, for diagnostic imaging. They are intended to reflect what is considered by ISUOG to be the best practice at the time at which they are issued. Although ISUOG has made every effort to ensure that Guidelines are accurate when issued, neither the Society nor any of its employees or members accepts liability for the consequences of any inaccurate or misleading data, opinions or statements issued by the CSC. The ISUOG CSC documents are not intended to establish a legal standard of care, because interpretation of the evidence that underpins the Guidelines may be influenced by individual circumstances, local protocol and available resources. Approved Guidelines can be distributed freely with the permission of ISUOG (

To quantify birth prevalence and spectrum of congenital heart disease in the Island population of Malta, and compare these rates with previous studies. All patients diagnosed as having congenital heart disease by echocardiography, cardiac catheterization, surgery or post-mortem by 1 year of age between 1990-1994 were included. There were 231 cases of live born congenital heart disease with a birth prevalence of 8.8/1000 live births. The commonest lesions were ventricular septal defect, pulmonary stenosis and tetralogy of Fallot. The rates of individual lesions were compared with two recent epidemiological studies with similar methodologies. Although the overall birth prevalence of congenital heart disease was similar in three studies, significantly higher rates of pulmonary stenosis, tetralogy of Fallot and double outlet right ventricle were found in Malta, all of which predispose to right ventricular outflow tract obstruction. In contrast, there were lower rates of lesions causing left ventricular outflow tract obstruction. A higher rate of ventricular septal defect was also found. The Maltese gene pool may contain an inherent predisposition towards lesions causing right ventricular outflow tract obstruction.