Congenital heart disease: clinical characterization in newborns from a referral hospital, Manaus, Amazonas, Brazil

Abstract

In Brazil, the impact of congenital heart disease (CHD) remains obscured by limited data, especially in the northern region. For this reason, our study seeks to uncover the prevalence and clinical variations of CHD in Manaus, Amazonas. This study followed a cross-sectional model performed in 110 newborns with CHD diagnosed between March 2022 to April 2023. Complex CHD was present in about 80% of the newborns, which increased the risk of requiring multiple surgical interventions. We found and characterized 19 CHD phenotypes, with a higher prevalence of complex CHD cases. We documented 12 fatalities, mostly attributed to septic and cardiogenic shock related to complex CHD with high levels of urea, creatinine, AST, ALT, CRP, GGT, NT-proBNP and acidosis (p<0.001). Our findings suggest a close relationship between CHD and a systemic impact with chronic/acute kidney failure and hepatopathies. Inadequate data from the information system on live births (SINASC) results in underreporting and increased CHD mortality rates, emphasizing the urgency for new strategies to enhance case identification and improve early diagnosis of critical CHD with important systemic repercussions.