Craniofacial characteristics of patients with heart disease

Children with congenital heart disease commonly experience delayed growth. Studies comparing growth and development of these children generally found that they have decreased height and weight, but with no information on craniofacial growth. The aim of this study was to evaluate the craniofacial characteristics of patients with heart disease.

We used lateral head cephalograms of 131 patients, aged 8 to 12, attending the Department of Pediatrics of the Hospital of the State University of Rio de Janeiro in Brazil on a routine basis. The study group comprised 50 boys and 38 girls with congenital heart disease. The control group included 20 boys and 23 girls with no heart disease. The skeletal, dental, growth, esthetic, and vertical patterns were analyzed with several cephalometric measurements. The chi-square test was applied to verify a possible association between sex and heart disease, and the Student t test was used to verify differences between the groups of patients with and without heart disease.

Heart disease is not sex-related (chi-square = 0.267). But some measurements had sex differences in the groups with and without heart diseases. The Student t test showed significant differences between the groups in the SNA angle measurement in male patients (P = 0.032), and in ANB angle (P = 0.002) and the relationship of the lower lip to the Steiner line (P = 0.034) in the girls.

Skeletal patterns were characterized by maxillary protrusion in the boys with heart disease and by increased ANB angles in the girls without heart disease. The esthetic pattern showed a more pronounced lower lip in the girls without heart disease. However, from a clinical point of view, these were slight and irrelevant alterations. The results suggest that patients suffering from heart disease have similar craniofacial characteristics to those without this condition.