Skip to main content
PMC home page
British Heart Journal logoLink to British Heart Journal
. 1984 Sep;52(3):248–257. doi: 10.1136/hrt.52.3.248

The presentation of symptomatic heart disease in infancy based on 10 years' experience (1973-82). Implications for the provision of services.

D J Scott, M L Rigby, G A Miller, E A Shinebourne
PMCID: PMC481621  PMID: 6466510

Abstract

The diagnoses and age at presentation of 1665 infants with symptomatic heart disease, who were admitted to the Brompton Hospital, London, during the period 1973-82 were reviewed. The frequency of certain conditions had changed during the period of the study. Complete transposition of the great arteries and critical aortic stenosis had become less common, whereas the frequency of right ventricular outflow tract obstruction, and of critical pulmonary stenosis in particular, had increased. Several conditions, including coarctation of the aorta, hearts with univentricular-atrioventricular connexion, and double outlet ventricle, formed a higher proportion of cases in the present series than in the New England Regional Infant Cardiac Program study, whereas the proportion of cases of atrial septal defect, hypoplastic left heart syndrome, and pulmonary atresia with intact septum was smaller. Most of the cyanotic infants presented during the first 14 days of life at the time of ductal closure. As expected this was also true of other duct dependent circulatory disorders such as aortic coarctation and interrupted aortic arch. Acyanotic infants with potentially large left to right shunts tended to present during the second month of life, when the pulmonary vascular resistance fell. This study emphasises that most symptomatic infants with heart disease present during the first two months of life. As a consequence the provision of expert neonatal and infant medical services is an integral part of any paediatric cardiac service.

Full text

PDF
255

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bound J. P., Logan W. F. Incidence of congenital heart disease in Blackpool 1957-1971. Br Heart J. 1977 Apr;39(4):445–450. doi: 10.1136/hrt.39.4.445. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bull C., Deanfield J., de Leval M., Stark J., Taylor J. F., Macartney F. J. Correction of isolated secundum atrial septal defect in infancy. Arch Dis Child. 1981 Oct;56(10):784–786. doi: 10.1136/adc.56.10.784. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. CARLGREN L. E. The incidence of congenital heart disease in children born in Gothenburg 1941-1950. Br Heart J. 1959 Jan;21(1):40–50. doi: 10.1136/hrt.21.1.40. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Dickinson D. F., Arnold R., Wilkinson J. L. Congenital heart disease among 160 480 liveborn children in Liverpool 1960 to 1969. Implications for surgical treatment. Br Heart J. 1981 Jul;46(1):55–62. doi: 10.1136/hrt.46.1.55. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Feldt R. H., Avasthey P., Yoshimasu F., Kurland L. T., Titus J. L. Incidence of congenital heart disease in children born to residents of Olmsted County, Minnesota, 1950-1969. Mayo Clin Proc. 1971 Dec;46(12):794–799. [PubMed] [Google Scholar]
  6. Hoffman J. I., Christianson R. Congenital heart disease in a cohort of 19,502 births with long-term follow-up. Am J Cardiol. 1978 Oct;42(4):641–647. doi: 10.1016/0002-9149(78)90635-5. [DOI] [PubMed] [Google Scholar]
  7. MITCHELL S. C. The ductus arteriosus in the neonatal period. J Pediatr. 1957 Jul;51(1):12–17. doi: 10.1016/s0022-3476(57)80275-3. [DOI] [PubMed] [Google Scholar]
  8. Macartney F. A better deal for newborns with congenital heart disease. Arch Dis Child. 1979 Apr;54(4):268–270. doi: 10.1136/adc.54.4.268. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Mitchell S. C., Korones S. B., Berendes H. W. Congenital heart disease in 56,109 births. Incidence and natural history. Circulation. 1971 Mar;43(3):323–332. doi: 10.1161/01.cir.43.3.323. [DOI] [PubMed] [Google Scholar]
  10. RICHARDS M. R., MERRITT K. K., SAMUELS M. H., LANGMANN A. G. Congenital malformations of the cardiovascular system in a series of 6,053 infants. Pediatrics. 1955 Jan;15(1):12–32. [PubMed] [Google Scholar]
  11. Report of the New England Regional Infant Cardiac Program. Pediatrics. 1980 Feb;65(2 Pt 2):375–461. [PubMed] [Google Scholar]
  12. Shinebourne E. A., Tam A. S., Elseed A. M., Paneth M., Lennox S. C., Cleland W. P. Coarctation of the aorta in infancy and childhood. Br Heart J. 1976 Apr;38(4):375–380. doi: 10.1136/hrt.38.4.375. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Tynan M. J., Becker A. E., Macartney F. J., Jiménez M. Q., Shinebourne E. A., Anderson R. H. Nomenclature and classification of congenital heart disease. Br Heart J. 1979 May;41(5):544–553. doi: 10.1136/hrt.41.5.544. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES