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Prevalence of undiagnosed congenital cardiac defects in older children*

Published online by Cambridge University Press:  01 August 2008

Monesha Gupta-Malhotra ,
Archana Dave ,
Brian C. Sturhan ,
Karen McNiece ,
P. Syamasundar Rao  and
Ronald Portman
Monesha Gupta-Malhotra*
Affiliation:
Division of Pediatric Cardiology, Children’s Memorial Hermann Hospital, University of Texas Health Science Center at Houston, Houston, Texas, United States of America Division of Pediatric Nephrology, Children’s Memorial Hermann Hospital, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
Archana Dave
Affiliation:
Division of Pediatric Cardiology, Children’s Memorial Hermann Hospital, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
Brian C. Sturhan
Affiliation:
Division of Pediatric Nephrology, Children’s Memorial Hermann Hospital, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
Karen McNiece
Affiliation:
Division of Pediatric Nephrology, Children’s Memorial Hermann Hospital, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
P. Syamasundar Rao
Affiliation:
Division of Pediatric Cardiology, Children’s Memorial Hermann Hospital, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
Ronald Portman
Affiliation:
Division of Pediatric Nephrology, Children’s Memorial Hermann Hospital, University of Texas Health Science Center at Houston, Houston, Texas, United States of America
*
Correspondence to: Monesha Gupta, MBBS, Division of Pediatric Cardiology, Co-Director, Fetal Echocardiography, Clinical Director, Pediatric Hypertension, Children’s Memorial Hermann Hospital, University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 3130, Houston, Texas 77030, USA. Tel: +713 500 5743; Fax: +713 500 5751; E-mail: [email protected]
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Abstract

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.

Keywords

Ebstein’s malformationbicuspid aortic valvemitral valvar prolapse
Type
Original Article
Information
Cardiology in the Young , Volume 18 , Issue 4 , August 2008 , pp. 392 - 396
Copyright
Copyright © Cambridge University Press 2008

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Footnotes

*

The presentation on which this work is based was given at the Inaugural Meeting of the World Society for Pediatric and Congenital Heart Surgery, held in Washington, District of Columbia, May 3 and 4, 2007.

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