Congenital heart disease in the adult - abstract

ABSTRACT

This study is an analysis of eighty (80) cases of congenital heart disease seen in adults at the San Fernando General Hospital. This diagnosis was based on history, physical examination, chest X-Ray, electrocardiography, M-mode echocardiography, two-dimensional echocardiography and contrast two-dimensional echocardiography. Seventy per cent (70 percent) of the cases had septal defect, thirty-five per cent (35 percent) atrial and thirty-five per cent (35 percent) ventricular. Patent ductus arteriosus accounted for 12.5 per cent and cyanotic congenital heart disease 10 per cent. There were two cases of coarctation of the aorta, two of pulmonary stenosis and one each of aortic stenosis and anolamous pulmonary venous return. Females exceeded males by 21. Fifty-two per cent (52 percent) of the cases were in the age group 12 - 20 years and twenty-five per cent (25 percent) were older than age 30. Moderate to severe pulmonary hypertension was present in 23 cases - two patent ductus arteriosus, nine atrial septal defect and twelve ventricular septal defect. Shunt reversal was demonstrated with contrast two-dimensional echocardiography in five cases of ASD and six cases of ventricular septal defect. Two patients had corrective surgery - one closure of ASD at age 32 and the other repair of Fallot's tetralogy at age 17. After cardiac catherization two patients were considered inoperable because of severe pulmonary hypertension and poor ventricular function. Six patients died from congential heart disease. Three had trial septal defect with severe pulmonary hypertension, one each had ventricular septal defect, coarctation of the aorta and cyanotic congenital heart disease. The majority of our patients have defects which are surgically correctable with low mortality. The introduction of open-heart surgery in Trinidad in the near future should improve the prognosis of these patients (AU)