Latest update November 8th, 2024 1:00 AM
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GPHC sees high prevalence of paediatric heart disease
– specialist
Since its inception last year, the Echocardiography Laboratory at the Georgetown Public Hospital Corporation (GPHC) has performed 186 paediatric echocardiograms (tests to monitor or diagnose heart disease).
And according to Dr Melanie Willimann, who specialises in General Paediatrics at the University of Calgary in Alberta, Canada, 70 per cent of the echocardiograms revealed notable cardiac abnormalities.
Dr. Melanie Willimann
This, according her, suggests a high prevalence of structural heart disease in children in the Guyanese Community.
Dr Willimann’s revelations were in fact the findings of an observational descriptive study she conducted, along with two of her colleagues; doctors Frank Dicke and Debra Isaac, at the GPHC Echo Lab. The study spanned a period of July 2012 through October 2013 during which time data, specifically demographics and diagnosis, was obtained from the Lab report database.
The findings of the study were presented when the GPHC hosted the Sixth Guyana Medical Scientific Conference at the Guyana International Conference Centre (GICC) recently.
The GPHC’s Echocardiography Education Programme was first developed last year as a combined effort of the Libin Cardiovascular Institute of the University of Calgary, the GPHC Institute for Health Sciences Education and the local Ministry of Health.
And, according to Dr Willimann, the programme is one designed to provide high level, sustainable, cardiac ultrasound diagnostics for both adults and children.
Moreover, the study was intended to analyse the paediatric echocardiograms performed since the introduction of the Echo Lab in order to determine the prevalence and types of structural cardiac diseases within the population.
As such Dr Willimann’s report outlined that “it is very notable that many of the children with serious congenital abnormalities have not been diagnosed or definitely treated promptly after birth.” This delay, she pointed out, is associated with irreversible complications and worse outcomes than if the diagnosis is made and treatment is initiated early. But with the Echo Lab in place, she assured that the GPHC “provides capability for accurate congenital cardiac diagnosis, allowing these children to be successfully identified, treated, followed and/or referred for repair in a more timely fashion.”
She highlighted too that a systematic programme for referral for assessment, including echocardiograpgy for infants and children with suspected cardiac disease, can facilitate management and improve outcomes for this under-diagnosed population.
Since the establishment of the Lab, a total of 568 echocardiograms were performed, of which 209 have been done on patients below the age of 18. And according to Dr Willimann, “after removing duplicate reports and studies with incomplete data, the 186 paediatric echocardiograms were included in the analysis. Of these 186 studies, 56 (30 per cent) were normal and 130 (70 per cent) had findings requiring follow up or interventions.”
Twenty-four of the paediatric cases, Dr Willimann said, showed relatively minor abnormalities, that is, those requiring repeat studies and follow-up in the future to assess for worsening, but no acute treatment. The remaining 106, she noted, demonstrated significant findings requiring more urgent management and closer follow-up. “These abnormalities included large atrial septal defects (ASD), ventricular septal defects (VSD), Tetralogy of Fallot, complex congenital heart abnormalities, congenital and rheumatic valvular disease and other diagnoses,” explained Dr Willimann.
Of note too was the fact that the study was able to deduce that the majority of echocardiograms done were performed on non-hospitalised children in the community who were not receiving acute care.
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