Abstract
Background: Patterns of heart diseases differ between the high income countries and low income countries. 1, 2 Acquired heart diseases like RHD, cardiomyopathies, pericarditis are still a public health burden while congenital heart diseases still carry a poor outcome among children(3). The absence of early diagnosis, surgical intervention and inadequate access to medication and the existing burden of communicable diseases increases the strain on a staggering economy of most sub Saharan countries.
Aim: To assess the clinical and echocardiographic pattern of cardiac disease in children in Kordofan state and to develop a road map plan of their further management.
Methods: An analytical cross sectional hospital based study. The study included the children of age groups 1 day up to 18 years with diagnosed or strongly suspected congenital or acquired cardiac disease who have their follow up in the pediatric sections of El-Obied hospitals in the western central part of the Sudan. Every child in the study group was assessed clinically with focused history taken and relevant physical examination. Chest x-ray and proper echocardiography was done for every child in the study group. Management plan was put by the pediatric cardiologist for all the children in the study group. Eighty children were enrolled in this study.
Results: 80 children studied, 55% were males and females represent 45%. Most of the children with cardiac disease in the study were from the age group 1-5 years (27.5%) followed by infants (26.2%). after that, 5-10 years, more than 10 years and less than one month. Nine patients (11.25%) were severely affected, 26 (32.5%) were moderately affected and the growth of 45 (56.25%) was normal. Clinical evaluation of the study group revealed that, 19 children (24%) presented with respiratory symptoms and / or respiratory distress. A cardiac murmur was heard in most of the patients in this series, systolic murmurs heard in 55 patients (69%) of which 21 were pansystolic (26%) and 8 were ejection systolic murmurs (10%). Hepatomegaly was found in 25 patients (31%) and Hepatosplenomegaly in 4 patients (5%). Down syndrome was found in 5 patients (6%), William syndrome in one patient. Congenital HD found in 56 patients (70%) and acquired HD in 24 (30%), 19 patients (79% of the acquired heart disease and 23.7% of the total study group was diagnosed as having rheumatic heart disease and cardiomyopathy was found in 5 patients (20.8% of acquired heart disease).
Conclusion: Rheumatic cardiac disease is preventable through the proper and complete antibiotic treatment of streptococcal pharyngitis and tonsillitis and it is vital to apply and strict to the recommendations of the national program of prevention of rheumatic fever and rheumatic heart disease.