Congenital heart disease (CHD) is defined as abnormality in ‘cardio circulatory’ structure or function that is present since birth. Incidence being 8 CHD’s per 1000 live births. Early establishment of diagnosis is important as newer available treatment modalities can significantly decrease mortality and morbidity. With limited resources in developing countries like India clinical acumen still forms the back bone of diagnosis and later to be confirmed by echocardiography and to deliver the appropriate management at the right time.
Aims and Objectives: To study the correlation between clinical diagnosis [Detail history/clinical examination/CXR/ECG] and 2D Echocardiography diagnosis.
Methodology: Patients from newborn to 12 years of age with features suggestive of congenital heart disease admitted in department of pediatrics, Dr. D.Y. Patil Medical College and Research Centre, Pune were enrolled during study period i.e. October 2013 to September 2015 who fulfilled the inclusion and exclusion criteria.
A standard proforma was used during initial evaluation to get the detailed history and the examination findings along with CXR and ECG were evaluated and clinical diagnosis is ascertained and subjected to 2D echocardiographic evaluation to confirm the diagnosis.
Results: Out of 54 cases 5 were clinically diagnosed as cyanotic CHD( TOF 7.4%, TGA+VSD 1.8%) and 49 as acyanotic CHD(VSD 29.6%, ASD 25.9%, PDA 25.9%, CoA 3.7%, AS 1.8%, PDA+CoA 1.8%, ASD+VSD 1.8%). Clinic-echocardiographic diagnosis is correlated, partially correlated and not correlated in 68.5%, 18.5% and 13% of cases respectively.
Conclusion: Properly carried out clinical examination, X-ray and ECG evaluation are important tools in arriving at a near accurate diagnosis in CHD. However, to confirm the diagnosis echocardiography has to be carried out. Until sophisticated diagnostic tools are widely available in developing countries, thorough clinical examination, chest X-ray, ECG has a Significant role to play in arriving at a near accurate diagnosis.