Spectrum of congenital heart diseases in early childhood (1–60 months): insights from a sub-himalayan tertiary care centre

ORIGINAL ARTICLE

Spectrum of Congenital Heart Diseases in Early Childhood (1–60 months): Insights from a Sub-Himalayan Tertiary Care Centre

Meenu Yadav¹, Seema Sharma¹, Shikha Verma¹, Milap Sharma¹, Kavya Sharma².

¹Department of Pediatrics, Dr Rajendra Prasad Government Medical College, Tanda, Kangra, India,
²Maharishi Markandeshwar University, Solan, India.

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Abstract
Background: Congenital heart disease (CHD) is a leading cause of birth defect-related mortality, with delayed diagnosis common in resource-limited regions. In India, gaps in CHD detection and care persist, especially in remote areas like Himachal Pradesh. This study evaluates the spectrum and outcomes of CHD in early childhood at a Sub-Himalayan tertiary care centre.
Objective: To study the spectrum and outcomes of congenital heart disease (CHD) in children aged 1 month to 5 years in a tertiary hospital of the sub-Himalayan region.
Methods: This prospective observational study was conducted over a period of one year, from December 2023 to December 2024. Children aged 1–59 months with echocardiographically confirmed CHD were enrolled. Clinical details and outcomes were recorded during follow-up.
Results: Seventy children (19.2per 1000) were diagnosed with CHD. Among them, 67% were infants, with a female preponderance (male: female ratio 0.9:1). Acyanotic lesions comprised 81%, most commonly ventricular septal defect (34%), atrial septal defect (28%), and patent ductus arteriosus (15%). Tetralogy of Fallot (14%) was the main cyanotic lesion. Congestive heart failure occurred in 35 children. Ten underwent surgery, and four deaths were recorded.
Conclusion: CHD is a significant burden in early childhood, with prevalence of 19.2/1000 recorded in this cohort. It contributed to substantial morbidity (50%) and mortality (5.7%).

Why this article important?

Our study demonstrates a high prevalence of congenital heart disease(CHD), with 19.2 per 1,000 children in the one-month to five-year age group. This significant burden highlights the ongoing challenge of undetected and late-presenting CHD. Many neonates and children with critical CHD continue to have poor survival due to delayed diagnosis and limited access to specialised paediatric cardiac care centres. The findings underline the urgent need for strengthening early screening, referral pathways, and treatment facilities. National health programmes such as Rashtriya Bal Swasthya Karyakram and Ayushman Bharat have strong potential to address these gaps and improve outcomes if effectively implemented.Notably, 60% of surgeries in this study were supported under the RBSK scheme, reflecting the importance of public programs in improving access.

Summary of article

Dear Sir, We wish to submit our original research article entitled “Spectrum of Congenital Heart Diseases in Early Childhood (1–60 months): Insights from a Sub-Himalayan Tertiary Care Centre” for consideration for publication in your journal. We confirm that the contents of this manuscript have not been published elsewhere, in whole or in part, and are not under consideration for publication in any other journal. There is no overlap with any of our prior publications. All authors have contributed substantially to the conception and design of the study, data collection, analysis and interpretation of results, and preparation of the manuscript. All authors have read and approved the final version of the manuscript and agree to be accountable for all aspects of the work.

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