Where There is No Echocardiography: an Overview of the Diagnosis of Paediatric Heart Diseases in a New Paediatric Cardiology Unit at the University of Port Harcourt Teaching Hospital

Abstract

Background: The Paediatric Cardiology unit of the University of Port Harcourt Teaching Hospital (UPTH) was set up in March 2005 and a consultant paediatrician interested in Cardiology was mandated by the Paediatric Department to attend to the increasing number of patients with cardiac diseases.

Objective: To report our experience in the clinical diagnosis of heart diseases without modern diagnostic tools, in the first two years of a new Paediatric Cardiology unit.

Methods: This was a prospective study carried out between March 2005 and February 2007 using detailed history, physical examination and a Flow Table.

Results: Forty-nine children (29 males, 20 females), M: F= 1.5:1, with age range of eight days to 13 (mean 3.50+4.52) years, were seen. Ventricular septal defect was the commonest cardiac defect in 36.7 percent followed by Tetralogy of Fallot in 20.4 percent. The diagnosis was 68 percent accurate when compared with echocardiography (ECHO) diagnosis in 19 patients. Six patients had surgery, 12 were lost to follow-up, and seven (14 percent) have died. The remaining 24 are either receiving medications and/or are awaiting surgery.

Conclusion: History and clinical examnination remain the mainstay of cardiac diagnosis in the absence of specialized tools such as an echocardiogram. Training of Fellows in Paediatric Cardiology and equipping of Federal and State government hospitals are of utmost necessity.

Keywords: New cardiology unit, paediatric patients, echocardiography