Clinical screening tool for early detection of congenital heart disease in children living at high altitude
DOI:
https://doi.org/10.18203/2349-3291.ijcp20242336Keywords:
CHD, Clinical screening tool, Early detectionAbstract
Background: Congenital heart diseases (CHD) have a high morbidity and mortality and its early detection is critical. The aim of the study is to develop a clinical screening tool for early detection of children with congenital heart disease at high altitude.
Methods: This was a hospital based cross sectional study. All children between age 0 to 1 year visiting the OPD and admitted in indoor services of pediatrics with suspected heart disease based on pre-defined clinical criteria were evaluated for development of clinical screening tool for prediction of presence of CHD using parameters; heart rate (HR), respiratory rate (RR), ratio of HR/RR, pulse oximetry, presence of precordial pulsations and murmurs. Then diagnostic performance of these tools was calculated by using ECHO as a gold standard test.
Results: A total of 102 study participants were included in our study. Among the total, 79 (77.5%) had underlying CHD. Result was considered positive if any of them was pres ent. In children age less than one year living at high altitude suspected to have high risk for presence of CHD and/or arterial oxygen saturation of less than 87.2%, this screening tool has sensitivity of 78.79% and specificity of 66.67%.
Conclusions: This study concluded that combination of screening tools along with pulse oximetry in the community settings of developing countries are better in early detection and timely management of CHD than using these tests/ parameters alone.
References
Chessa M, Taha FA. Congenital Heart Diseases. In: Alvarenga, M., Byrne, D. (eds) Handbook of Psychocardiology. Springer, Singapore; 2016:407-437.
Vaidyanathan B, Satish G, Mohannan ST, Sundaram KR, Warrier KKR, Kumar RK. Clinical screening for congenital heart disease at birth: A prospective study in a community hospital in Kerala. Indian Pediatr. 2011;48:25-30.
Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002;39:1890-900.
Saxena A. Congenital heart diseases in India-A status report. Indian J Paediatr. 2005;72(7):595-8.
Adams FH, Emmanouilides GC. Moss' heart disease in infants, children and adolescents. In Moss' Heart disease in infants, children and adolescents. 1983.
Wren C, Reinhardt Z, Khawaja K. Twenty-year trends in diagnosis of life-threatening neonatal cardiovascular malformations. Arch Dis Childhood Fetal Neonatal Edition. 2008;93(1):F33-5.
Kuehl KS, Loffredo CA, Ferencz C. Failure to diagnose congenital heart disease in infancy. Pediatrics. 1999;103(4):743-7.
Arlettaz R, Bauschatz AS, Mönkhoff M, Essers B, Bauersfeld U. The contribution of pulse oximetry to the early detection of congenital heart disease in newborns. Eur J Pediatr. 2006;165(2):94-8.
Singh M. Care of the Newborn, 8th ed. Singh M (ed): CBS Publishers and Distributors Pvt. Ltd, New Delhi. 2004.
Gersony WM, Hayes CJ, Driscoll DJ, World Health Organization. Apitz C, Webb GD, Redington AN. Tetralogy of Fallot. Lancet. 2009;374(9699):1462-71.
Alter BP, Czapek EE, Rowe RD. Sweating in congenital heart disease. Pediatrics. 1968;41(1):123-9.
Shah I. Heart disease. Pediatr Oncall J. 2009;6(1):7.
Izhar FM, Abqari S, Shahab T, Ali SM. Clinical score to detect congenital heart defects: Concept of second screening. Ann Pediatr Cardiol. 2020;13(4):281-8.
Owayed AF, Campbell DM, Wang EE. Underlying causes of recurrent pneumonia in children. Arch Pediatr Adolescent Med. 2000;154(2):190-4.
Mehrizi A, Drash A. Growth disturbance in congenital heart disease. J Pediatr. 1962;61(3):418-29.
Moss AJ. Clues in diagnosing congenital heart disease. West J Med. 1992;156(4):392.
Schobesberger D, Kriz K, Breier M. Design and production of the Himachal Pradesh topographic overview map, 1: 500,000. Cartographic Perspect. 2010;1(67):43-50.
Venkateshwar V, Raman TR. Failure to thrive. Med J Armed Forces India. 2000;56(3):219-24.
Gupta H, Anand S, Grover N, Negi PC. Pulse Oximetry for the Early Detection of Congenital Heart Diseases. Int J Med Res Prof. 2017;3(4):227-31.
Mohsin M, Humayun KN, Atiq M. Clinical screening for congenital heart disease in newborns at a tertiary care hospital of a developing country. Cureus. 2019;11(6):e4808.
Mathur NB, Gupta A, Kurien S. Pulse Oximetry Screening to Detect Cyanotic Congenital Heart Disease in Sick Neonates in a Neonatal Intensive Care Unit. Indian Pediatr. 2015;2:769-72.
Kim J, Ariefdjohan M, Sontag M, Rausch C. Pulse oximetry values in newborns with critical congenital heart disease upon ICU admission at altitude. Int J Neonatal Screening. 2018;4(4):30.
