PATTERN OF CONGENITAL HEART-DISEASE IN KING-FAHD-SPECIALIST-HOSPITAL,BURAIDAH

Three hundred and twenty (84.5%) of 379 cardiac patients studied in th e Pediatric Cardiology Unit of King Fahd Specialist Hospital, Buraidah , between August 1988 and October 1991 had congenital heart disease. B oth sexes were equally affected. Ventricular septal defects were the m ost common lesions (relative frequency 38.5%), followed by atrial sept al defect (11.5%), pulmonary valve stenosis (9%), and patent ductus ar teriosus (8%). Compared with American and European children, our patie nts had a paucity of obstructive aortic lesions (5% versus 10.9%), and an excess of atrial septal defects (11.5% versus 6.7%) and atrioventr icular canal defects (5% versus 2.4%). The latter appeared to be due t o the relatively high incidence of trisomy-21 in our patients, which w as present in 32 (50.7%) of the 63 patients with identified etiology; that is, in 10% of the 320 patients as against a reported incidence of about 5% in other series. This comparatively high incidence was, in t urn, attributable to the relatively advanced age (mean 34.0+/-8.3 year s) of the mothers of the trisomic children. The cumulative detection r ate was suboptimal: 29% at age one month, 53% at six months, and 60% a t one year. There is, therefore, a need for increased awareness, espec ially among primary health and other front-line doctors, and earlier c ase detection.