Study of congenital heart disease in neonates: clinical profile, diagnosis, immediate outcome and short-term follow-up

Abstract

Background: Congenital heart disease (CHD) occurs in approximately 0.8% of live births. Early recognition of CHD is important for appropriate management and decision making regarding referral. The purpose of this study was to document the common presenting symptoms and signs in the neonates with CHD, definitive diagnosis and short-term follow-up for six months.Methods: Sixty full term neonates with suspected CHD admitted in neonatal intensive care unit (NICU) at Niloufer Hospital, Hyderabad during the period December 2016 to May 2017 were included in the study.Results: Of the 60 neonates, most common age of presentation was for first week (45%, n = 27). Of the 60 neonates, 32 (54%) were males and 28 (46%) were females. The commonest presentation was hurried respiration (68%), followed by feeding problem (63%) and only eight neonates were asymptomatic with clinically significant murmur. 40% (n = 24) of the babies were born of consanguineous marriage. 72% (n = 43) of babies presented with murmur and 6 babies had extra-cardiac manifestations. Babies with acyanotic CHD were 38 (63%) of which ventricular septal defect (VSD) was the commonest. Cyanotic CHD were 22 (37%) of which transposition of great arteries (TGA) was the commonest. 25 babies (42%) expired during neonatal period. Of the remaining babies during follow-up, 29 % of babies thrived well, 35% presented with repeated respiratory tract infections, 21% with failure to thrive and 15% with congestive heart failure (CHF).Conclusions: Neonates with CHD have a unique presentation and they carry poor outcome unless diagnosed early and managed appropriately. Babies presenting with multiple anomalies should be screened for any underlying structural heart disease.