Assessment of the prevalence of congenital heart disease in children with pneumonia in tertiary care hospital: A cross-sectional study

Abstract

Background and objectives Pneumonia is the most common cause of death in children under five years of age. Epidemiological factors and the disease burden differ in developing and industrialized countries. The present study is a cross sectional observational study, carried out from August 2018 to August 2020 in Hindu Rao Hospital, to assess the prevalence of congenital heart disease (CHD) in patients with pneumonia in children up to 5 years. The main objectives of the study were to study the prevalence of congestive cardiac failure (CCF) in pneumonia with and without congenital heart disease. Material and methods Patients under 5 years of age, presenting with pneumonia during August 2018 to July 2020 were enrolled for study. The bio-data of each patient was documented each patient was clinically evaluated thoroughly and findings noted. Pneumonia was diagnosed on typical history, physical findings, blood investigations and chest radiographic finding of pneumonia infiltrates in either one or both lung fields. All the cases of pneumonia underwent transthoracic 2 Dimensional (2D) and Doppler echocardiography, done by the cardiologist. Any congenital heart disease so found was noted. The type and size of the defects was documented. The ventricular septal defects were classified based on the site and size. The size of the patient ductus arteriosus was also determined. These measurements were taken to evaluate the impact of defect size on pneumonia. CCF was diagnosed when the patient fulfilled the clinical diagnostic criteria of heart failure. All the cases of pneumonia underwent transthoracic 2 Dimensional (2D) and Doppler echocardiography for diagnosis of any congenital heart disease. Results Mean age of the children with pneumonia was 9.94 months with 77.5% of the cases below 1 year of age. Male predominance was seen with 56.3% males to 43.8% females. Prevalence of congenital heart disease among cases of pneumonia was 12.5% while that of congestive heart failure was 27.5%. Most common CHD observed was VSD (14 cases; 8.8%) followed by PDA, ASD and TGA (4; 2.5% and 3; 1.9% and 1; 0.6% cases respectively). A significant association was observed between presence of congenital heart disease and development of CCF. Conclusion Our study demonstrates that most patients with pneumonia or recurrent pneumonia are likely to have an underlying illness at the time of pneumonia. Recurrent ALRTI often occurred in children with history of congenital heart diseases (CHD) and is also associated with Congestive Cardiac Failure. Children with CHD are more vulnerable to recurrent respiratory tract infection.

The value of modified Ross score in the evaluation of children with severe lower respiratory tract infection admitted to the pediatric intensive care unit

“…Similar result was obtained by Jat et al [ 14 ] who stated that the most common symptoms for patients with congestive cardiac failure (CCF) were respiratory distress (84%), hepatomegaly (81%), feeding difficulty (79.4%), diaphoresis (50%), and poor weight gain (3.2%).…”

“…Our reported rate of HF development among patients with LRTI was much higher than the rate reported by most of above mentioned studies [ 12 – 14 ]; this may be attributed to that we included all pediatric patients with LRTI, also we excluded patients with past history of CCH which is a known risk factor for developing LRTI [ 15 ].…”

“…Also Ýlten and his colleagues found an incidence of congestive heart failure in 14% among 50 children with pneumonia [ 12 ], Navarro et al reported HF in 8.5% of the studied cases [ 13 ], and Kabir et al reported that 9 (25%) children developed heart failure [ 8 ]. And recently Jat et al reported lower rate as the authors reported that out of 140 cases of pneumonia without CHD 28 (20.0%) had CCF [ 14 ].…”

Prevalence of Pneumonia with Congenital Heart Disease in Children at District Dera Ismail Khan, Pakistan

“…The most significant and prevalent predisposing factors for pneumonia are immune system diseases, such as those seen in severe congenital immune deficiencies, malnutrition, and acquired immune deficiencies (Owayed et al, 2000;Jat et al, 2022). Although early childhood indications of congenital problems in the small left-to-right shunts, such as recurrent LRTI and failure to thrive, can exist, it is still important to screen this population of kids for CHD.…”

Heart Disease Risk Factors in Adolescent Women

“…Pada ras suku kulit hitam, 65% di antaranya berjenis kelamin perempuan dan mempunyai pengetahuan yang cukup baik tentang penyakit jantung akan tetapi justru lebih rentan terhadap penyakit jantung dibandingkan laki-laki (23). Di kalangan masyarakat penyakit jantung selalu dikaitkan dengan usia tua (27).…”