Significance of heart murmur in diagnosis of congenital heart disease in newborn babies

This study was conducted to determine the clinical and echocardiographic evaluation of neonate with heart murmur and contribution of neonatal examination especially presence or absence of cardiac murmur in the detection of congenital heart disease [CHD]. The study was carried out in neonatology unit in althawra teaching Hospital-albaida Libya during the-period from January 2009 to January 2010. Neonates having heart murmur or when there were some clues to doubt CHD like cyanosis, respiratory distress, heart failure and echocardiography were done for all. CHD were classified according to the structural defect with the echocardiographic findings. Total 722 neonates were admitted during one year period. Heart murmurs were found in 81 cases. Out of 8 leases 34 [41.9%] had CHD confirmed by echocardiography. Another 9 neonates were found to have CHD without murmur after echocardiography. In total 43 [5.9%] neonates had CHD. Infant with CHD may present with or without murmur. Clinical examination with Careful auscultation is mandatory in the initial evaluation of neonates to identify CHD. The infant having suggestive features for CHD with or without murmur should undergone echocardiography, so that appropriate management and early intervention can be done

Spectrum of congenital heart defects associated with down syndrome in Aljabel Al Akhdar/Libya

A prospective study to identify the pattern of congenital heart defects [CHD] in children with Down Syndrome [DS] and compare it with CHD in children without DS in Libyan population in specific area in the eastern part of Libya, aljabel alakhdar [10,000 km2 and 200,000 population]. All children with DS referred to the cardiac Clinic from June 2007 to July 2010 formed the subjects [Group I]. Children without DS seen at the clinic during the same period served as controls [Group II] Two-dimensional echo-Doppler studies were performed on both groups and the results compared. CHD were detected in 27/43 [63%] children in Group I, compared to 348/1152 [30.2%] in Group II [P<0.001]. The common CHD in Group I included atrial septal defect [ASDII; 10/27], AVSD [4/27], Patent ductus arteriosus [PDA; 6/27] and ventricular septal defect [VSD; 6/27], and in Group II included ASD [101/348], VSD [87/348], patent ductus arteriosus [58/348], pulmonary stenosis [PS; 35/348] and AVSD [2/348]. AVSD was more common [P<0.001] and PS less common [P=0.03] in Group I. Aortic stenosis, coarctation of aorta, transposition of great arteries, Tetrology of Fallot [TOF] and complex heart diseases were not detected in group I. A high frequency of CHD was documented in DS-children; ASD was most frequent in DS. An interesting observation was the relative rarity of some CHD in the DS population studied

Congenital heart disease in infants of diabetic mother's echocardiographic study

Study of neonates born to Mothers with diabetes mellitus [including Gestational diabetes] to detect the spectrum of congenital heart disease [CHD] using non-invasive echocardiographic screening. Between October2007 and January 2010, a prospective study of68 infants of diabetic mothers [IDMs] at Al-thawra teaching Hospital in Albaida-libya was arranged. .Family and maternal history included, cardiovascular system examination and echocardiography were performed. Total of 68 IDMs examined, Echocardiographic findings were: patent foramen oval [72%].PDA [53%], ventricular septal defect both muscular and membranous [10%], atrial septal defect [6%], and valvular pulmonary stenosis [<2%], peripheral pulmonary stenosis [6%] Hypertrophied interventricular septum was seen in 60% of cases. Tetrology of fallot [3%], Hypo plastic left heart syndrome one case [<2%], TGAnot seen in this group of study, other complex cardiac Topography account 1.5%, isolated coarctation of aorta<2%. Overall incidence of congenital heart disease was 25% [without PDA, PFO, septum hypertrophy, peripheral PS]. Maternal diabetes is a significant risk factor for CHD. Careful evaluation and early diagnosis of CHD in this high-risk group are highly recommended and there is a need for development of postnatal screening programs for CHD in this risk group in our population, also our policy of antenatal hyperglycemia control need to be reviewed