Clinical Study on Congenital Heart Diseases in Korean Adult

ABSTRACT

A clincal study was made on 383 adult patients with congenital heart disease who visited the Seoul National university Hospital during the period of March, 1961-July, 1979. 1. The incidence of congenital heart disease for the consecutive years was increasing in 1970s, especially in recent two years. 2. The sex incidence of congental heart disease was female 47.0%, male 53.0%, with male preponderance in tetralogy of Fallot, ventricular septal defect, coarctation of aorta, aortopulmonary window and female preponderance in atrial septal defect, patent ductus arteriosus. 3. Age distribution of congenital heart disease showed that 79.1% of all were below 30 years of age but atrial septal defect showed wide distribution below and above 30 years of age. 4. The incidences of each congenital heart disease were atrial septal defect 20.9%, tetralogy of Fallot 20.6%, ventricular septal defect 19.%, patent ductus arteriosus 12.0%, pulmonary stenosis 7.6%, trilogy of Fallot 1.8%, Ebstein's anomaly 1.8%, ventricular septal defect with pulmonary stenosis 1.3%, coarctation of aorta 1.3%, ventricular septal defect with aortic insufficiency 1.0%, transposition of great vessels 1.0%, in order and rare and various combined anomalies. 5. Average duration of illness in congenital heart disease was less than 15 years in majority, but duration from 11 years to 20 years was most common in tetralogy of Fallot. 6. Functional class of congenital heart disease is class II and I in majority, but class III was most common in tetralogy of Fallot. 7. Comparision of precatheterization diagnosis with postcatheterization diagnosis showed concordence in 92.2% and comparison of postcatheterization diagnosis with postoperative diagnosis showed concordence in 95.5% of cases. 8. Electrocardiographic findings in 5 major congenital heart disease were observed as follows; right ventricular hypertrophy 86.3%, right atrial enlargement 16.4% in tetralogy of Fallot, right ventricular hypertrophy 30.9%, incomplete right bundle branch block 27.9% in atrial septal defect, left ventricular hypertrophy 28.8%, right ventricular hypertrophy 10.6%, biventricular hypertrophy 10.6% in ventricular septal defect, left ventricular hypertrophy 63.2% in patent ductus arteriosus and right ventricular hypertrophy 70% in pulmonary stenosis. 9. Postoperative changes in electrocardiographic findings were observed in 36.1% of operated patients, of whom teteralogy of Fallot 61.7%, ventricular septal defect 48.0% were most common. Pstoperative electrocardiographic changes were complete right bundle branch block 58.3%, incomplete right bundle branch block 11.7%, myocardial ischemia 10%, nonspecific ST-T changes 10%, etc. in order.