Clinical accuracy of post graduate student in diagnosing congenital heart diseases (CHD) using an algorithmic approach and its comparison with echocardiography
Journal Title: Pediatric Review: International Journal of Pediatric Research - Year 2018, Vol 5, Issue 3
Abstract
Background: Congenital heart diseases (CHDs)are an important cause of morbidity and mortality in children. In view of poor availability of resources in developing nations like India, clinical evaluation of children with CHD is important. Aim: To study the clinical accuracy of post graduate student in diagnosing congenital heart diseases and its comparison with echocardiography. Subjects and Methods: A prospective cross-sectional study performed in the Department ofPediatrics of a tertiary level teaching hospital in central India. Participants were children with CHDs attending outpatient department or admitted in wards or PICU. History, general physical and cardiovascular examinations were recorded by the post graduate student. Chest X-ray and ECG were obtained. These findings were used to classify the defect using an algorithm and a clinical diagnosis was made which was matched with echocardiography.Kappa coefficient test was used to judge the degree of agreement between the two methods. Results: 80 patients with CHDs were included in the final analysis. 49 (61.25%) had acyanotic CHDs and ventricular septal defect (VSD) was the most common defect (n= 24, 30%) while tetralogy of Fallot (TOF) was the most common (n=14, 17.5%) cyanotic CHD. Concordance of clinical diagnosis and echocardiography was maximum for VSD (16/24, 66.6%) in acyanotic group and TOF (8/14, 57%) in cyanotic group. Kappa’s coefficient test analysis also showed an "almost perfect" area of agreement for VSD (κ=0.87) and fair area of agreement for TOF (κ=0.65). For type of CHD (cyanotic or acyanotic) and type of ventricular hypertrophy (left, right or biventricular) it showed “almost perfect” and“fair” area of agreement respectively. Conclusion: Agreement between echocardiography and cclinical diagnosis of CHDs including hemodynamic parameters like type of ventricular hypertrophy and pulmonary arterial hypertension was reasonably accurate in our study.
Authors and Affiliations
Nirbhay Mehta, Swati Bhalse
Keywords
Related Articles
- EP ID EP374337
- DOI 10.17511/ijpr.2018.3.09
- Views 134
- Downloads 0
Study of hyper bilirubinemia in Low Birth Weight (LBW) and Normal Birth Weight (NBW) babies
Introduction: Neonatal hyper bilirubinemia implies significant jaundice usually above 15mg/dl or requiring treatment. About 60-70% of all term newborns develop some degree of jaundice while in LBW babies it goes upto 80%...
Clinical profile of severe anemia in adolescents from a hilly terrain tertiary care hospital in north India
Introduction: Adolescence is a vulnerable period for development of anemia. Anemia in adolescence has serious implications for a wide range of outcomes. It causes reduced resistance to infection, impaired physical growth...
Patent ductus arteriosus – clinical profile and outcome after treatment in a tertiary care hospital
Background: Patent ductus arteriosus (PDA) is the commonest congenital heart disease seen in neonatal ICU. Methods: A prospective observational study was conducted in the neonatal intensive care unit of Vydehi institute...
Clinico-laboratory profile and mortality in plasmodium falciparum and vivax malaria in a tertiary centre
Introduction: Malaria is a disease of global health importance and currently, 95% of the Indian population lives in malaria endemic area. Malaria parasite profile has been changing significantly over the years and is res...
Study of neonatal jaundice in a tertiary care centre of South India
Hyperbilirubinemia is a common problem during the neonatal period occurring in up to 60% of term and 80% of preterm babies in the first week of life. Some of the most common causes of neonatal jaundice include physiologi...