Joshi A, Shrestha R Pb, Shrestha P S, Dangol S, Shrestha N C, Poudyal P, Shrestha A
Department of Pediatrics, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.
Kathmandu Univ Med J (KUMJ). 2016;14(55):239-243.
Background Congenital Heart Disease and Rheumatic Heart Disease are the most common childhood cardiac disease encountered in developing countries. Objective To study the pattern and the prevalence of cardiac diseases, its age wise distribution and to determine their risk factors for mortality in children presented to Dhulikhel Hospital, Kathmandu University Hospital. Method A study of cardiac diseases in children, since birth to 16 years of age attending the department of pediatrics in Dhulikhel Hospital, Kathmandu University Hospital was done over a period of 30 months (Jan 2014 to June 2016). The pattern of disease was studied. Detailed clinical examination of all cases was done followed by the necessary relevant investigations including electrocardiography, chest x-ray, echocardiography and supportive laboratory investigations. Result In this study period, 218 pediatric cardiac cases were encountered, among which 144 cases (66.05%) were Congenital Heart Disease, 57 cases (26.14%) were Rheumatic Heart Disease, 14 cases (6.42%) were Pericardial Disease and 3 cases (1.37%) were classified as Dilated Cardiomyopathy. Majority of Congenital Heart Disease were of isolated Ventricular Septal Defect (25%) and isolated Atrial Septal Defect (20.13%) followed by Patent Ductus Arteriosus (9.02%), Tetralogy of Fallot (6.94%) and Complex Congenital Heart Disease (6.25%). All of the Rheumatic Heart Disease primarily involved the Mitral Valve; however combined Aortic Valve involvement was seen in 26.31% of cases. All the 14 cases of pericardial disease presented with pericardial effusion and two cases presented with constrictive pericarditis. All the cases of pericardial disease were investigated to be of tubercular in origin. Conclusion Septal defects are the most common Congenital Heart Disease encountered in children. Although the prevalence of Rheumatic Heart Disease is decreasing worldwide, it is still a big burden in our community. Tubercular pericardial effusion is still not uncommon and should be suspected with a child presenting with pericardial effusion. Increased level of cardiac care and corrective surgeries are needed for children with cardiac disease in Dhulikhel Hospital, Kathmandu University Hospital.
先天性心脏病和风湿性心脏病是发展中国家最常见的儿童心脏病。目的：研究加德满都大学医院杜利凯尔医院收治儿童心脏病的类型、患病率、年龄分布及其死亡危险因素。方法：对杜利凯尔医院、加德满都大学医院儿科自出生至16岁的儿童心脏病进行了为期30个月（2014年1月至2016年6月）的研究。研究疾病类型。对所有病例进行详细临床检查，随后进行包括心电图、胸部X光、超声心动图及辅助实验室检查在内的必要相关检查。结果：在本研究期间，共收治218例儿科心脏病病例，其中144例（66.05%）为先天性心脏病，57例（26.14%）为风湿性心脏病，14例（6.42%）为心包疾病，3例（1.37%）归类为扩张型心肌病。先天性心脏病中大多数为单纯室间隔缺损（25%）和单纯房间隔缺损（20.13%），其次为动脉导管未闭（9.02%）、法洛四联症（6.94%）和复杂先天性心脏病（6.25%）。所有风湿性心脏病主要累及二尖瓣；然而，26.31%的病例合并主动脉瓣受累。14例心包疾病均表现为心包积液，2例表现为缩窄性心包炎。所有心包疾病病例经检查均为结核性病因。结论：间隔缺损是儿童中最常见的先天性心脏病。尽管全球风湿性心脏病患病率在下降，但在我们社区仍是一个沉重负担。结核性心包积液仍然并不罕见，对于有心包积液表现的儿童应予以怀疑。杜利凯尔医院、加德满都大学医院的心脏病患儿需要加强心脏护理水平及进行矫正手术。
