Clinicopathological analysis of heart disease in pediatric age group

Heart diseases are important cause of childhood morbidity and mortality,

Heart disease in children can be congenital or acquired,

Congenital heart diseases are group of heart diseases present since birth,

They are the most common form of birth defects and are the leading cause of birth defect related deaths,

Congenital heart diseases are classified into cyanotic and acyanotic heart diseases,

Acyanotic heart diseases are more common than cyanotic heart disease,

There is left to right shunt in acyanotic heart disease causing right heart hypertrophy and pulmonary hypertension,

In cyanotic heart disease there is right to left shunt of the blood,

This leads to deoxygenated blood entering systemic circulation causing hypoxemia and cyanosis,

Acquired heart diseases are illnesses that occur after birth,

They are a heterogenous group of disorders that arise from damage to the heart and blood vessels by a variety of causes including ischemic hypoxic metabolic nutritional inflammatory and infectious processes,

Common acquired heart disease includes rheumatic heart disease myocarditis and pericardial diseases,

Others include Kawasaki disease and cardiomyopathies,

Heart diseases may be symptomatic or asymptomatic,

Often when heart diseases are asymptomatic they may go undiagnosed or there is delay in diagnosis, This results in grave consequences,

Symptomatic children may show cardiac specific or non-specific symptoms,

Cardiac specific symptoms include cyanosis, breathlessness suck rest suck cycle chest pain and palpitations,

Non specific symptoms include poor weight gain failure to thrive and diaphoresis,

Certain acquired heart diseases may show systemic involvement like fever with rash in Kawasaki disease or migratory polyarthritis in rheumatic heart disease,

With time, there has been a lot of advancement in medical research and technology,

There has been development in the level of cardiac care provided to pediatric population,

However still gross disparity exists in terms of equitable distribution of available resources and their utility,

Furthermore data collected regarding childhood heart disease in low and middle income countries is often poor underestimating the disease burden,

Many of the times signs and symptoms like poor growth or lethargy may be the initial presenting complaint,

Hence the underlying actual cause can get misdiagnosed,

This has led to significant consequences like mortality in pediatric population,

It is well known that autopsy has been a great tool in retrospectively assessing the accuracy of clinical diagnosis

Although there has been significant decline in the number of autopsies over the years autopsy remains an important parameter in retrospectively assessing an undiagnosed or misdiagnosed illness,

The aim of this study is to document the clinical profile etiology and pattern of fatal heart diseases in children in whom autopsy was done in a tertiary care hospital,

We also aim to analyze the level of concordance between the ante mortem clinical diagnoses and post mortem autopsy diagnoses in these children and identify red flags or risk factors for mortality in children having heart disease