Factors linked with the delayed diagnosis of congenital heart diseases. A single center experience from a tertiary care hospital of Pakistan.

Abstract

Objective: To note the factors linked with delayed diagnosis of congenital heart diseases (CHDs) among children. Study Design: Cross-sectional study. Setting: Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan. Period: September 2022 to February 2023. Material & Methods: We analyzed children aged up to 15 years who presented for the first time with echocardiographic evidence for the diagnosis of CHDs. Socio-demographic data along with clinical information like gender, age, residential status, maternal education status, history of maternal fetal echocardiography and the frequency of delayed diagnosis of CHDs were noted on a specially made proforma. Parent or guardians were asked for possible reasons of delayed diagnosis for CHDs. Results: In a total of 250 children, the mean age was 2.33±3.81 years while 162 (64.8%) children were aged below 2 years. There were 138 (55.2%) boys. Residential status of 159 (63.6%) children was rural while maternal educational status of 99 (39.6%) was illiterate. There were 164 (65.6%) children who were diagnosed to have cyanotic CHDs while 86 (34.4%) had acyanotic CHDs. Frequency of delayed diagnosis was noted among 182 (72.8%) children. In these 182 cases, delayed first consultation was the commonest factor behind delayed diagnosis noted in 78 (42.9%) children while missed diagnosis by the pediatrician was the 2^nd most common factors linked with the delayed diagnosis of CHDs as described by 62 (34.1%) parents. Conclusion: Almost 3/4^th of the studied children had delayed diagnosis of CHDs while cyanotic CHDs were the most common CHD types. Delayed first consultant and missed diagnosis by the pediatrician were the most common factors linked with delayed diagnosis of CHDs.