Pattern of congenital heart disease in King Fahd Specialist Hospital, Buraidah.

Three hundred and twenty (84.5%) of 379 cardiac studied in the Pediatric Cardiology Unit of King Fahd Specialist Hospital, Buraidah, between August 1988 and October 1991 had congenital heard disease. Both sexes were equally affected. Ventricular septal defects were the most common lesions (relative frequency 38.5%), followed by atrial septal defects (11.5%), pulmonary valve stenosis (9%), and patent ductus arteriosus (8%). Compared with American and European children, our patients had a paucity of obstructive aortic lesions (5% versus 109%), and an excess of atrial septal defects (11.5% versus 6.7%) and atrioventricular canal defects (5% versus 2.4%). The latter appeared to be due to the relatively high incidence of trisomy-21 in our patients, which was present in 32 (50.7%) of the 63 patients with identified etiology; that is, in 10% of the 320 patients as against a reported incidence of about 5% in other series. This comparatively high incidence was, in turn, attributable to the relatively advanced age (mean 34.0 +/- 8.3 years) of the mothers of the trisomic children. The cumulative detection rate was suboptimal: 29% at age one month, 53% at six months, and 60% at one year. There is, therefore, a need for increased awareness, especially among primary health and other front-line doctors, and earlier case detection.