Cardiac screening in congenital spine disorders

Area of Science:

• Pediatric Orthopedics
• Pediatric Cardiology
• Congenital Disorders

Background:

• Children with congenital spine disorders often present with congenital heart disease.
• The clinical presentation of these cardiac defects requires examination.
• Hypothesis: Cardiac anomalies are clinically obvious, negating the need for routine screening post-orthopedic referral.

Purpose of the Study:

• To investigate the presentation of congenital heart disease in children with congenital vertebral abnormalities.
• To determine the necessity of electrocardiogram (ECG) or echocardiogram screening for occult cardiac disease in this population.

Main Methods:

• Retrospective review of 190 children with congenital vertebral abnormalities (excluding myelodysplasia and sacral agenesis).
• Analysis of cardiac screening methods: echocardiogram, ECG with consultation, or orthopedic evaluation only.
• Data categorized based on pre-existing cardiac anomaly diagnosis.

Main Results:

• 24 children had a known congenital heart disease at orthopedic referral.
• One child detected with bicuspid aortic valve via echocardiogram (general population prevalence).
• No cardiac abnormalities found in children screened with ECG or orthopedic evaluation alone; no additional abnormalities found on follow-up (2-17 years).

Conclusions:

• Congenital heart disease associated with congenital spine disorders is typically clinically evident before orthopedic referral.
• Routine orthopedic referral for ECG or echocardiogram screening is not supported by these findings.