Diagnosis and management of adults with congenital heart disease: the experience of the Sudan Heart Centre

ABSTRACT

Adults with congenital heart disease [ACHD] constitute an increasing burden on cardiology service worldwide. All patients with congenital heart disease [CHD] 18 years of age or more seen at the Sudan Heart Centre by a paediatric cardiologist from July 2004-April 2009 were included in this retrospective review. Their clinical and echocardiographic features as well as their outcome were recorded. In the study period 2680 patients with CHD were evaluated at the clinic. One hundred and thirty patients with ACHD [4.8% of patients with CHD] were identified. The age ranged between 18-65 years. Males were 69 [53. 1%] and females 61 [46.9%]. The most common cardiac defects were Tetralogy of Fallot and atrial septal defect [23% each] followed by ventricular septal defect [15%]. 15% of those with large shunts were found to have Eisenmengers' syndrome. Our final diagnosis matched the referral diagnosis in 30% of patients. In 30% the final diagnosis was different and in the other 40% the referral diagnosis was partially matching the final diagnosis. Co-existing conditions included systemic hypertension, diabetes mellitus, cerebrovascular accidents, endocarditis and pregnancy. Surgical/catheter interventions were done in 46 patients [35%]. Catheter treatment included patent ductus arteriosus, atrial and ventricular septal defect closure as well as pulmonary valve balloon dilatation with acceptable results. ACHD is a growing specialty and, early diagnosis and treatment is necessary to prevent irreversible complications. Training of more staff in diagnostic and interventional technologies is warranted