Detecting CHDs

How are CHDs detected at birth? Are they even tested for? Of course every doctor listens to a baby's heart, but time and again they do not report murmurs (which are frequent and can often be harmless in small children). Many times babies "blue" but are sent home anyway. The following is an article from 2005 posted recently on a list serv on CHIN that tells about the latest trends in detecting CHD.

The evolution of diagnostic trends in congenital heart disease: A
population-based study
* V Grech
1Paediatric Department, St. Luke’s Hospital, Guardamangia, Malta
Correspondence to: V Grech
Senior Registrar, Paediatric Department of St. Luke’s Hospital,
Guardamangia, Malta. Fax: 240176; email: victor.e.grech@magnet.mt

Objective: To analyse historical trends in diagnosis of congenital heart
disease (CHD) in all diagnosed cardiac malformations born between 1945
and 1994 in a population-based study, the first of its type.

Methodology: Retrospective analysis of age and mode of diagnosis was
carried out in 953 patients with CHD, in the setting of a regional
hospital providing diagnostic and follow up services for all of Malta.
Main outcome measures were age at diagnosis, cumulative percentage
diagnosis by age and mode of diagnosis.

Results: A significant negative correlation of age at diagnosis with
time was found for both lesions not requiring intervention, and
requiring intervention (P < 0.0001). Cumulative percentage diagnosis by
age increased progressively with time. Echocardiography increased the
birth prevalence of definitively diagnosed defects, particularly of
lesions not requiring intervention. The annual number of cardiac
catheters for these conditions has decreased with an increased number
and proportion of interventional catheters. The current catheterization
rate for CHD is 6.1/100,000 population.

Conclusion: Echocardiography has led to an increase in the diagnosis in
the birth prevalence of CHD, and provided early diagnosis, supplanting
cardiac catheterization as a primary diagnostic tool.
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http://pediatrics.aappublications.org/cgi/content/full/115/1/95
Published online January 3, 2005
PEDIATRICS Vol. 115 No. 1 January 2005, pp. 95-101
(doi:10.1542/peds.2004-0516)