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Published on: May 5, 2018
Prevalence of undiagnosed congenital cardiac defects in older children
Monesha Gupta-Malhotra1, Archana Dave, Brian C Sturhan
1Division of Pediatric Cardiology, Children's Memorial Hermann Hospital, University of Texas Health Science Center at Houston, Houston, Texas 77030, USA. monesha.gupta@uth.tmc.edu
Insights
Undetected congenital heart defects are surprisingly common in children over one year old. Echocardiography revealed previously unsuspected cardiac defects in 3.5% of children evaluated, highlighting the need for early diagnosis.
Area of Science:
- Pediatric Cardiology
- Diagnostic Imaging
- Congenital Heart Disease
Background:
- Congenital cardiac defects can remain asymptomatic and undetected for years.
- Early identification is crucial for timely intervention and management.
Purpose of the Study:
- To determine the prevalence of congenital cardiac defects in children over one year of age.
- To assess the utility of echocardiography in detecting these defects.
Main Methods:
- Echocardiography was performed on 143 children (age 1-19 years) with systemic hypertension.
- The standard protocol aimed to identify end-organ damage and congenital cardiac defects.
Main Results:
- A congenital cardiac defect was found in 5 (3.5%) of the evaluated children.
- Four of these defects were previously undetected, including Ebstein's malformation, coronary arterial anomaly, bicuspid aortic valve, and mitral valve prolapse.
- One patient had a small ventricular septal defect.
Conclusions:
- Transthoracic echocardiography identified previously unsuspected congenital cardiac defects in 4 out of 143 children.
- Three cases required further management by a pediatric cardiologist.
- The prevalence of congenital heart malformations may be higher than previously thought, suggesting increased consideration for echocardiography when clinically indicated.
Background:
Certain congenital cardiac defects may go undetected for several years due to lack of symptoms and signs. Our purpose was to determine the prevalence of such defects among children greater than one year of age.
Methods:
The study was performed on subjects diagnosed with systemic hypertension, aged from 1 to 19 years, with a mean of 12.4 years, in whom we performed echocardiography, using a standard protocol, to establish any end-organ damage or to reveal any congenital cardiac defects.
Results:
We found a congenital cardiac defect in 5 (3.5%) of the 143 children evaluated. Of these, 4 had not previously been detected, specifically Ebsteins malformation of the tricuspid valve, with moderate regurgitation, a coronary arterial anomaly, a bicuspid aortic valve, and prolapse of the mitral valve permitting regurgitation. In the other patient, we found a non-significant tiny muscular ventricular septal defect.
Conclusions:
Our transthoracic echocardiographic investigation revealed previously unsuspected congenital cardiac defects in 4 of 143 older children, with 3 of these requiring further management by a paediatric cardiologist. A similar prevalence has also been reported in older children evaluated echocardiographically for other diseases such as insulin-resistance and leukemia. Hence, it is possible that the prevalence of congenitally malformed hearts is higher than previously reported. When clinically indicated, clinicians should more readily consider obtaining an echocardiogram to help in the identification of such malformations.
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