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The pattern and frequency of congenital heart disease among blacks
Insights
Congenital heart defects are common in Black patients, with ventricular septal defect and patent ductus arteriosus being most frequent. Many cases of congenital heart disease may go undiagnosed in this population.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Medical Genetics
Background:
- Congenital cardiac malformations represent a significant health concern across all age groups.
- Understanding the prevalence and types of these defects is crucial for effective diagnosis and treatment.
- Previous studies have explored racial differences in cardiac malformation frequencies, with varying conclusions.
Purpose of the Study:
- To report the types and frequencies of cardiac malformations in a cohort of 804 Black patients.
- To investigate potential racial predilections in the occurrence of specific congenital heart defects.
- To assess the prevalence of congenital heart disease within the broader spectrum of heart disease in Black individuals.
Main Methods:
- Retrospective analysis of 804 Black patients diagnosed with cardiac malformations.
- Diagnosis confirmation through cardiac catheterization, surgical procedures, or autopsy.
- Data collection on patient demographics, specific malformations, and co-existing conditions.
Main Results:
- The most common anomalies identified were ventricular septal defect, patent ductus arteriosus, and tetralogy of Fallot.
- In infants under one year, complete transposition of the great vessels was a notable finding.
- Congenital cardiac malformations constituted 26% of heart disease in Black patients of all ages and 53% in those 15 years or younger.
- No significant racial predilection for differences in cardiac malformation frequency was observed, with coarctation of the aorta rates comparable to white populations.
Conclusions:
- Ventricular septal defect, patent ductus arteriosus, and tetralogy of Fallot are the predominant cardiac malformations in the studied Black population.
- The frequency of congenital heart disease is substantial in Black patients, particularly in younger age groups.
- A significant number of congenital heart disease cases may be underdiagnosed in Black individuals, highlighting a need for increased awareness and diagnostic efforts.
Abstract:
The types of cardiac malformations in 804 black patients of all ages in whom the diagnosis was confirmed by cardiac catheterization, surgery or autopsy are reported. The most frequent anomalies were ventricular septal defect, patent ductus arteriosus and tetralogy of Fallot. Among infants under 1 year of age, complete transposition of the great vessels accounted for the third-largest group of malformations. While pulmonary venous anomalies were extremely rare and hypoplastic left heart defects rare in the neonate, it is not considered that a racial predilection for differences in the frequency of various cardiac malformations exists. The frequency of coarctation of the aorta in the group as a whole was not lower than that found in studies among whites. Among black patients of all ages with heart disease (studied in a hospital environment) congenital cardiac malformations ranked as the second most common form of heart disease with a frequency of 26%. Among children aged 15 years or less, congenital heart disease ranked first with a frequency of 53%. It is suggested that a diagnosis of congenital heart disease is not made in the majority of blacks born with such malformations.