Clinical Epidemiology And Management Of Congenital Heart Defects In A Developing Country

ABSTRACT

Congenital heart defects (CHD) remain one of the most common categories of birth defects worldwide. In many developing countries, high early childhood mortality and limited diagnostic facilities often obscure the true scope of the problem. In this review, we provide an overview of the clinical epidemiology and management of CHD in a developing country: Nigeria, Africa's most populous country. We describe the types of CHD and the clinical presentation, echocardiographic diagnosis, management, and outcome of CHD. Ventricular septal defects are the commonest CHD reported in Nigeria while tetralogy of Fallot is the commonest cyanotic CHD. Their etiology is often unknown, although the congenital rubella syndrome and Down syndrome account for a signicant minority of cases. Thus far, there is no modern genetic study of CHD in Nigeria. Diagnosis is often delayed, with only about half of CHD cases getting diagnosed within the 1st year of life and up to 10% diagnosed in adulthood. Echocardiography has played a major role in improving diagnosis. Management remains challenging, but a number of initiatives (especially by nongovernmental organizations) provide access to corrective surgery for a select few. The eld of CHD in Nigeria oers opportunities for research into etiology, natural history, clinical management, and outcomes.