Masood Sadiq, Bakht Roshan, Asjad Khan, Farhan Latif, Irfan Bashir, Sheryar A Sheikh.
Pediatric Heart Disease in Pakistan - epidemiological data on 6620 patients.
Pak Paed J Jan ;25(2):63-70.

Objective: To assess the pattern, age distribution and relative incidence of heart disease in all new pediatric patients aged 16 years and less. Design: A five year analysis of all children undergoing echocardiography for possible heart disease to a single center (May 1996 to April 2001). Setting: Tertiary referral center fur paediatric and adult cardiac services to the central and southern Punjab, Pakistan. Patients and methods: Data of all new children undergoing detailed echocardiography was reviewed for type of lesion, age at presentation and gender. Heart disease was divided into congenital heart disease and acquired heart disease. Results: Over a period of five years, 7400 new patients underwent detailed echocardiography. Of these, 662(1 were found to have a cardiac lesion while 780 patients were normal and excluded from the study. Of these 6620 patients, 4184 (63.2%) had congenital heart defects (CHD) while 2335 (35.3%) had acquired heart desease (AHD) and 101 (1.5%) were placed in miscellaneous group. Of CHD, ventricular septal defect was the most common lesion (32% of all patients with CHD), followed by atrial septal defects (13.2%) and persistent arterial duct (12.8%). Majority were males (65%) and the mean age of presentation was 5.8 years for acyanotic and 4.8 years for cyanotic heart defects. Tetralogy of Fallot was the most common cyanotic lesion (16.06%) with mean age of presentation being 4.2 years. The relative incidence of patients with critical heart lesions was much less and only 586 patients (14%) were under the age of one year at presentation. Children presenting less than one month of age were only 3% (127 patients). Amongst AHD, 71.5% (1670) had rheumatic heart disease (RHD) while 24.5% (572) had myocardial desease, clinically diagnosed as myocarditis or dilated cardiomyopathy. The mean age of presentation for myocarditis was 2.3 years and majority were clustered to the months of March, April and September, October, Amongst RHD, mitral regurgitation was the commonest lesion: 681 patients (40.8%) followed by mixed lesion of mitral & aortic regurgitation 382 patients (22%), and mitral stenosis, 264 patients (15.8%).

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