34 The profile of congenital cardiac services in northern sri lanka: a single centre study

PurposeThe Paediatric Cardiology Unit at Jaffna, Northern Sri Lanka was established recently with a single paediatric cardiologist serving a population of 1 million. This study was undertaken to assess demographics and frequency of congenital (CHD) and acquired (AHD) heart diseases and catheter interventions in this population. The proportion of antenatal diagnoses from a population of 17 000 livebirths per year was assessed.MethodsInformation on all patients referred between August 2013 and July 2017 was stored in a database.Results18 647 children and adults (11 956 new referrals) were studied. Most (69.5%) were referred with murmurs. Normal hearts were found in 62.8%. The commonest acyanotic heart disease was atrial septal defect (ASD). 3.91% had cyanotic disease; 1.5% had Tetralogy of Fallot and 0.54% had transposition of the great arteries. 2.58% had AHD of which 2% was rheumatic heart disease (RHD) and 0.58% was Kawasaki disease. Only 13 patients over 6 months old had cyanotic disease. CHD was diagnosed in 9 of 110 fetal referrals and confirmed postnatally. Cardiac catheterization was performed in 363 patients aged 3 days to 65 years with no mortality; 265 (75%) were interventional. Interestingly, most of these patients (236; 73%) were female.ConclusionIncidence of congenital heart diseases in Sri Lanka is similar to that in the West. Most cyanotic lesions are diagnosed early but antenatal diagnosis rates are still low. RHD is much more common than in the West and interesting gender biases in practice may have cultural origins that deserve further investigation.