Give the introduction to Congenital Heart Disease ?
The past 3 or 4 decades have witnessed a revolution in pediatric cardiac sciences. A number of conditions previously considered beyond repair are now repairable in early infancy and the outlook for patients with CHD is now vastly improved.
No systematic surveys have been conducted to estimate the incidence of CHD at birth in India and other developing countries. As a result there really is no information available about the CHD incidence at birth in India.
There are examples of studies that have surveyed school going children for CHD. School survey data from the Medical Sciences suggest a CHD prevalence of 2 per 1000. Clearly such studies cannot be used to determine the magnitude of CHD in the population because it does not account for the very high attrition of CHD.
Extrapolation of data from developed countries may give us a rough estimate of CHD prevalence at birth. Using statistics from the developed nations, it can be estimated that between 130,000 to 270,000 children are born with CHD each year in India. Approximately 80,000 newborns with CHD would require intervention during the neonatal period or infancy each year. Between 3-10 per cent of the present infant mortality may be accounted for by CHD. The overwhelming majority of children with CHD never reach a tertiary case institute could include failure to diagnose CHD, failure to recognize the need for early referral, lack of resources for transport and, costs of care of the newborn with CHD.
An action plan for better care for patients with CHI3 in India should address the following:
- Obtaining accurate information on CHD prevalence and mortality.
- Creating awareness among pediatricians and primary care givers about the importance of early detection and timely referral of neonates and infants with suspected CHD.
- Increasing the number of institutions that provide specialized pediatric cardiac services.
- Increasing the number and quality of trained personnel for pediatric cardiology and pediatric cardiac surgery.
- Improving the quality of care in the established institutions with pediatric cardiac services.