Abstract
TO STUDY THE CLINICAL PRESENTATION, ASSOCIATED EXTRA-CARDIAC ANOMOLIES AND OUTCOME OF PATIENTS OF NEONATAL CARDIAC DISORDERS

*Sheikh Quyoom Hussain, Zahid Akbar Mir and Ubaid Ullah Wani

ABSTRACT

Background: Congenital heart disease (CHD) is the commonest of all congenital lesions and is the most common type of heart disease among children.[1] Congenital heart diseases are not fixed anatomic defects that appear at birth, but are instead a dynamic group of anomalies that originate in fetal life and change considerably during the postnatal development.[2] The incidence of moderate-to-severe structural CHD in live born infant is 6–8 per 1000 live births.[3] About 2–3 per 1000 newborns will be symptomatic with heart disease in the 1st year of life. CHD is considered as one of the leading causes of neonatal mortality.[4] Aim: To study the clinical presentation, associated extra-cardiac anomolies and outcome of patients of Neonatal Cardiac Disorders. Material and Methods: It was an observational prospective study carried out in the Neonatology Section, Department of Pediatrics, GB Panth Childrens hospital Srinagar from November 2017 to August 2019. Results: During the two year study, 471 neonates were diagnosed with congenital heart disease in which 335 (71.1%) were acyanotic and 136 (28.9%) were cyanotic. Males and females comprised of 253 and 218 respectively with a male to female ratio of 1.2:1. Nearly half of the cases presented in the 4th week 217 (46.1%) followed by those in 3rd week 121 (25.7%), 2nd week 79 (16.8), and 1st week 54 (11.5%). the neonates presented with various symptoms of respiratory distress, feeding difficulty, and combination of symptoms; however, the most common presenting cardinal complaint was fast breathing in 201 (42.7%), followed by difficult feeding 98 (20.8%), cyanosis 83 (17.6%), shock manifested as decreased urinary output in 40 (8.5%), fast breathing and cyanosis were present in 21 cases (4.5%). Thirty-eight cases (5.9%) were asymptomatic and clinically only murmur was present. Associated (extra-cardiac) anomalies were seen in 87 (18.5%) in our study in which Down’s syndrome was the commonest association with congenital heart disease. The immediate outcome of the neonates showing 57 (41.9%) of cyanotic CHD died within one month whereas only 35 (10.4%) acyanotic CHD expiring at one month. Conclusion: congenital heart diseases in neonates have a varied presentation.high index of suspicion and early timely treatment should be done.

Keywords: congental heart diseases, cyanosis, acyanotic heart diseases. To study the clinical presentation, associated extra-cardiac anomolies and outcome of patients of Neonatal Cardiac Disorders


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