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Missed diagnosis of critical congenital heart disease a significant clinical problem
By Reuters Health
October 31, 2008

NEW YORK (Reuters Health), Oct 31 - While prenatal and postnatal diagnosis of congenital heart disease has improved over the past two decades, missed or delayed diagnosis still continues to be a significant problem, according to findings published in the October issue of the Archives of Pediatrics and Adolescent Medicine.

"Congenital heart disease affects eight to 12 per 1,000 live-born infants and is one of the most common and serious types of birth defects," Dr. Ruey-Kang R. Chang, of UCLA Medical Center, Torrance, CA, and colleagues write. "Many infants born with congenital heart disease are discharged from the hospital nursery with their conditions undiagnosed."

The researchers examined the rate of missed or late diagnoses of critical congenital heart disease in a population-based retrospective study of infants in California between 1989 and 2004.

A total of 898 infants who died of critical congenital heart disease within a year of birth who either did not undergo surgery or had an unknown surgery status were identified from statewide death registry data.

Of the 898 infants, 152 had a missed diagnosis of critical congenital heart disease. The median age at death for this group was 13.5 days. The most common diagnoses were hypoplastic left heart syndrome (n = 58) and coarctation of the aorta (n = 41).

"The detection of coarctation of aorta and hypoplastic left heart syndrome can be improved by prenatal echocardiography of high-risk pregnancy and careful cardiovascular examination of infants prior to nursery discharge," Chang commented in an e-mail to Reuters Health. "There have been debates on whether pulse oximetry screening should be performed on all infants prior to nursery discharge."

"Infant deaths due to missed or delayed CHD diagnosis, although uncommon, continue to be a significant problem," he added. "Such occurrences can be devastating for parents and families," Chang said. "As clinicians caring for infants, it is crucial to diagnose critical congenital heart disease early to prevent devastating events."

By Michelle Rizzo

Arch Pediatr Adolesc Med 2008;162:969-974.

Last Updated: 2008-10-30 15:09:43 -0400 (Reuters Health)

Related Reading

Fetal echocardiography detects major but may miss minor heart defects, March 28, 2008

Copyright © 2008 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.

Last updated np 10/30/2008 4:46:18 PM



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