Pattern of cardiac diseases in children in Pokhara, Nepal

Objective: The objective of the study was to point out the relative public health problems of cardiac diseases in childhood. Material and methods: A study of the cardiac diseases in children attending the Paediatric OPD of Manipal Teaching Hospital, Pokhara, Nepal was done over a period of 2 years. The idea was to see the pattern of diseases, as being a developing country, these diseases would be a large public health problem. 107 cases had been studied and it was found that 52% were congenital heart diseases and 25% were rheumatic heart diseases. Other cases included dilated cardiomyopathy, Pericardial diseases and a few cases of hypertension. All the cases were investigated by ECG, X-ray and echocardiographic studies. These cases are under follow up and some have undergone surgical treatment. Results: In this study in a short period of 2 years we had 107 cases of heart diseases of which 51% were CHD, 25% RHD and others were pericardial disease, DCM, hypertension and some had no demonstrable lesions. All the cases of RHD are being followed by regular Penicillin prophylaxis. Among them one has had mitral valve replacement done and 2 had mitral valvotomy. Of the CHD cases 5 cases have had VSD operated upon, one PDA also had surgery and one case of Fallot's is shortly going to undergo corrective surgery. Conclusion: Heart disease in neonates could be benign or very significant and a high level of suspicion and knowledge of physiology will differentiate between the two. Early recognition of CHD will help to treat the child and if possible get corrective surgery done. Similarly a history of rheumatic fever is important and all children need to be followed up till at least 18 years of age. Key words: CHD-congenital heart diseases, RHD- rheumatic heart diseases, DCM- dilated cardiomyopathy, VSD-Ventricular septal defect, ASD-atrial septal defect, PDA-patent ductus arteriosus.