Presented by Malouny SISAVANH, MD

MOST FREQUENT DISEASES IN PEDIATRIC CARDIOLOGY IN

NATIONAL CHILDREN’S HOSPITAL LAO PDR

Summary of Cases

* Repeated or follow-up exams included.† “Others” indicates any acquired cardiac problems from infectious, degenerative, and atherosclerotic causes.

*†

• From 2013-07-12 to 2013-11-19• Total 140 cases (including repeated or follow-up exams) - CHD: 33 cases - Others: 29 cases

Average: 1.5 case/day

Summary of Cases

* Repeated or follow-up exams excluded.† “Others” indicates any acquired cardiac problems from infectious, degenerative, and atherosclerotic causes.

*†

• From 2013-07-12 to 2013-11-19• Total 115 patients (excluding repeated or follow-up exams) - CHD: 25 patients - Others: 12 patients

Indication of TestIndication Number (%)

Routine check-up(including preoperative evaluation) 19 (16.5%)

Cardiac murmur 11 (9.6%)CXR abnormality

(Cardiomegaly / Pulmonary edema / Pleural effusion / Etc)

4 (3.5%)

Dyspnea / Hypoxemia / Heart Failure 13 (11.3%)Suspicious of Congenital Heart Disease(Specific indications were not provided) 21 (18.3%)

Suspicious of Kawasaki Disease 5 (4.3%)Suspicious of Infective Endocarditis 3 (2.6%)Suspicious of Diphtheric Myocarditis 1 (0.9%)

Chest pain 7 (6.1%)Palpitation / Arrhythmia 14 (12.2%)

Fatigue / Dizziness 13 (11.3%)Peripheral edema 2 (1.7%)

Unspecified 2 (1.7%)Total 115 patients (100.0%)

Details of PatientsCHD NumberPDA 6ASD 4VSD 3

ASD + PDA 3ASD + VSD 3

PDA + Bicuspid AoV 1ASD + VSD + PDA 1

Severe TR + ASD + VSD 1AVSD 1TOF 1Total 25 patients

Others NumberCardiac tamponade 1

Uremic cardiomyopathy 2

Coronary aneurysm (due to history of KD)

1

Kawasaki disease 1

Ischemic cardiomyopathy 1

Diastolic Heart Failure 1

Rheumatic MSR with ASR 1

Pericardial effusion 2

Infective endocarditis 1

Diphtheric myocarditis 1

Total 12 patients

Important Features

1. Undiagnosed and Unrepaired Congenital Heart Diseases are common in Adolescents or Adults

2. Cyanotic or Complex Congenital Heart Diseases are Rare

Insufficient neonatal screening

Lack of knowledge (patients / physicians)

Limited hospital accessibility

Problems1. Referral for Surgery is Limited

– Cardiac surgery is available only in Mahosot Hospital, performed by foreign volunteer doctors (from western countries)

– No cardiac surgery team in the Children’s Hospital– Post-operative outcome is unknown

2. Lack of Sedation System – EchoCG in the Children’s Hospital: Time- and Effort-consuming work

3. Economic and Social Situation – Patients/Parents cannot afford medical/surgical costs

4. Lack of Pathologic / Microbiologic / Serologic Laboratories– Routine laboratory tests are impossible or limited

Acknowledgement

• In-Chang Hwang, M.D (KOICA volunteer doctor in children’s hospital)