Congenital heart diseases in neonates

The incidence of congenital heart disease detectable by routine clinical examination has been estimated to be 7.5 per 1,000 live births . The incidence of congenital heart anomalies in neonates seen with detailed echocardiographic examination is four- to 10-fold higher.Small for gestational age neonates are at greater risk of congenital heart disease as many of the causes of intrauterine growth retardation are also major risk factors for development of congenital heart diseases.There are other important risk factors for development of congenital heart diseases including, consanguineous marriage, history of previous abortions, Maternal malnutrition, maternal diabetes and Preeclampsia.Patent ductus arteriosus was the most common anomaly found ( 28 %) followed by ventricular septal defect (18 %) and atrial septal defect (18 %),then Fallot’s tetralogy (12 %), Partial atrioventricular canal (8 %), transposition of great arteries (4 %) , complex anomaly (4 %), coarctation (2 %), dextrocardia (2%) and lastly the common atrioventricular canal (2 %).A heart murmur was the most common manifestation detected. Important clinical clues included cyanosis , heart failure and cardiomegaly.Echocardiography was used as the final court for the diagnosis of congenital heart diseases in our patients. Echocardiography dramatically reduces the requirement for invasive studies such as cardiac catheterization.The echocardiographic examination can be used to evaluate cardiac structure in congenital heart lesions, estimate intracardiac pressures and gradients across stenotic valves and vessels, quantitate cardiac contractile function (both systolic and diastolic), determine the direction of flow across a defect and examine the integrity of the coronary arteries..