Factors Contributing to Delayed Diagnosis of Congenital Heart Disease in Pediatric Population

Abstract

Objective: To analyze various factors contributing to delayed diagnosis of congenital heart disease (CHD) in pediatric population. Study Design: Cross-sectional study. Place and Duration of the Study: Department of Pediatrics and Department of Cardiology, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawalakot from January to December 2020. Material and Methods: A total of 265 children of both genders aged up to 15 years and presenting for the 1st time with the echocardiography confirmed diagnosis of CHD were enrolled. A special proforma was designed and questions were asked from parents/guardians of all study participants. Socio-demographic profile along with improper referral status and inadequate health facilities were noted. SPSS version 26.0 was used for statistical analysis. Qualitative variables like gender, area of residence, literacy status, socio-economic status, types of CHDs, delayed diagnosis (yes/no) and reasons for delayed diagnosis were represented as frequency and percentages. Results: In a total of 265 children included in the study, there were 156 (58.9%) male. Majority of the children, 184 (69.4%) were less than 2 years of age. Body weight below 3rd centile was noted in 164 (61.9%) children. Maternal fetal echocardiography was done in 13 (4.9%). Acyanotic CHD was noted in 180 (67.9%) children while remaining had cyanotic CHD 85 (32.1%). Delayed diagnosis of CHD was noticed in 211 (79.6%) children. Most common factor contributing to delayed diagnosis of CHD was found to be delayed 1st consultation in 85 (40.3%). Delayed or missed diagnosis by the doctor was the 2nd most frequent factor contributing to delayed diagnosis of CHD noted in 52 (24.6%) children. Delayed referrals were observed in 42 (19.9%) children. Conclusion: Delayed diagnosis of CHD was noted among 79.6% cases. Acyanotic CHD was the commonest type of CHD in the present study. Most common factors contributing to delayed diagnosis of CHD were delayed 1st consultation, delayed diagnosis by the doctor and delayed referrals. Keywords: Congenital heart disease, fetal echocardiography, delayed referrals