Volume 2 Issue 1 | 2025 | View PDF
Paper Id:IJMSM-V2I1P107
doi: 10.71141/30485037/V2I1P107

Epidemioclinical, Electrocardiographic And Cardiac Doppler Ultrasound Aspects Of Atrial Septal Defect In Children In Madagascar

Alda Randriantsoa, RijaMikhaël Miandrisoa, Herimasy Mahenintsoa Andriamahalaza, Dany Ravaoavy, Nirina Rabearivony

Citation:
Alda Randriantsoa, RijaMikhaël Miandrisoa, Herimasy Mahenintsoa Andriamahalaza, Dany Ravaoavy, Nirina Rabearivony, "Epidemioclinical, Electrocardiographic And Cardiac Doppler Ultrasound Aspects Of Atrial Septal Defect In Children In Madagascar" International Journal of Multidisciplinary on Science and Management, Vol. 2, No. 1, pp. 63-68, 2025.

Abstract:
Atrial septal defect is the 3rd most common congenital heart disease in children. It is a welltolerated cardiopathy, but its prevalence is underestimated. It is sometimes discovered at the stage of complications, which places a burden on management. Early diagnosis requires knowledge of this pathology, so that children can be referred to specialized centers for better care. The aim of this study was to obtain a database of epidemiological, clinical and echographic data on atrial septal defects in Madagascar, and to describe them in order to make suggestions for improving early diagnostic and therapeutic management. We conducted a retrospective cross-sectional descriptive and analytical study over a 20-year period. Data were analyzed using Epi-info with a significant threshold of less than 0.05. Prevalence was 10.28%. Females predominated (sex ratio 0.96), with a mean age of 86.02 months. The majority of children were asymptomatic (79.46%). Heart murmur (27%) and respiratory disease were the most common reasons for referral (Figure 1). The most common electrocardiographic abnormalities are right ventricular hypertrophy and right bundle-branch block. Cardiac Doppler ultrasonography revealed a predominance of the isolated ostium secondum type (65%) and the large size (45.09%). Repercussions were mainly dilatation of the right cavities (39.29%) and pulmonary hypertension (16.07%). Interventricular communication (16.96%), patent ductus arteriosus (10.71%) and pulmonary stenosis were the most common congenital cardiovascular anomalies. Large atrial septal defects were associated with hypertension. Early diagnosis should be promoted to avoid avanced stages of the disease.

Keywords: Atrial septal defect, Cardiac Doppler ultrasound, Child, Electrocardiogram, Epidemiology, Signs.

References:
1. C. Ward, “Secundum Atrial Septal Defect: Routine Surgical Treatment is Not of Proven Benefit,” British Heart Journal, vol. 71, pp. 219-223, 1994.
2. Yossef Teshome Zikarg, Chalachew Tiruneh Yirdaw, and Teshome Gebremeskel Aragie, “Prevalence of Congenital Septal Defects among Congenital Heart Defect Patients in East Africa: A Systematic Review and Meta-Analysis,” Plos One, vol. 16, no. 4, pp. 1-17, 2021.
3. Idrissa Basse et al., “Interauricular Communications in Children: Diagnosis and Treatment, About 49 Cases at the Children?s University Hospital in Dakar,” The Pan African Medical Journal, pp. 1-8, 2018.
4. E. Robert-Gnansia et al., “Epidemiology, Aetiology and Genetics of Congenital Heart Defects,” EMC - Cardiologie-Angéiologie, vol. 1, no. 2, pp. 140-160, 2004.
5. G. Kinda et al., “Congenital Heart Disease: Epidemiological and Echocardiography Aspects about 109 Cases in Pediatric Teaching Hospital Charles de Gaulle (CDG CHUP) in Ouagadougou, Burkina FASO,” vol. 20, pp. 1-7, 2015.
6. Shabnam Peyvandi et al., “Environmental and Socioeconomic Factors Influence the Live‐Born Incidence of Congenital Heart Disease: A Population‐Based Study in California,” Journal of the American Heart Association, vol. 9, no. 8, pp. 1-11, 2020.
7. J. Tikkanen, and O.P. Heinonen, “Risk Factors for Atrial Septal Defect,” European Journal of Epidemiology, vol. 8, pp. 509-512, 1992.
8. Ho Xuan Tuan et al., “Trends in the Prevalence of Atrial Septal Defect and Its Associated Factors among Congenital Heart Disease Patients in Vietnam,” Journal of Cardiovascular Development and Disease, vol. 7, no. 1, pp. 1-8, 2019.
9. Peter H. Langlois et al., “Urban Versus Rural Residence and Occurrence of Septal Heart Defects in Texas,” Birth Defects Research Part A: Clinical and Molecular Teratology, vol. 85, pp. 764-772, 2009.
10. Seth S. Martin, Edward P. Shapiro, and Monica Mukherjee, “Atrial Septal Defects – Clinical Manifestations, Echo Assessment, and Intervention,” Clinical Medicine Insights: Cardiology, vol. 8, no. 1, pp. 93-98, 2014.
11. Cammon B. Arrington et al., “An Assessment of the Electrocardiogram as a Screening Test for Large Atrial Septal Defects in Children,” Journal of Electrocardiology, vol. 40, no. 6, pp. 484-488, 2007.
12. Takekatsu Saito et al., “Natural History of Medium-Sized Atrial Septal Defect in Pediatric Cases,” Journal of Cardiology, vol. 60, no. 3, pp. 248-251, 2012.
13. Prof Tal Geva, Jose D Martins, and Rachel M Wald, “Atrial Septal Defects,” The Lancet, vol. 383, no. 9932, pp. 1921-1932, 2014.
14. Valérie Steiger Stolt et al., “Closure of Ostium Secundum Atrial Septum Defect with the Atriasept Occluder: Early European Experience,” Catheterization and Cardiovascular Interventions, vol. 75, no. 7, pp. 1091-1095, 2010.
15. CJ McMahon et al., “Natural History of Growth of Secundum Atrial Septal Defects and Implications for Transcatheter Closure,” Heart, vol. 87, pp. 256-259, 2002.
16. A. Motiwala et al., “Patients with Congenital Atrial Septal Defects: Effect of Age at Repair and Defect Size on Pulmonary Artery Pressures Prior to Repair,” The Thoracic and Cardiovascular Surgeon, vol. 59, no. 5, pp. 281-286, 2011.
17. Josephat Chinawa et al., “Predictors of Pulmonary Hypertension among Children with Atrial Septal Defects (ASD),” Libyan Journal of Medicine, vol. 17, no. 1, pp. 1-6, 2022.
18. Raysa Morales-Demori, “Congenital Heart Disease and Cardiac Procedural Outcomes in Patients with Trisomy 21 and Turner Syndrome,” Congenital Heart Disease, vol. 12, no. 6, pp. 820-827, 2017.
19. B. Stos et al., “Risks and Benefits of Cardiac Surgery in Down’s Syndrome with Congenital Heart Disease,” Archives of Pediatrics, vol. 11, no. 10, pp. 1197-1201, 2004.
20. Monica Tan et al., “Types and Distribution of Congenital Heart Defects Associated with Trisomy 21 in Singapore,” Journal of Paediatrics and Child Health, vol. 49, pp. 223-227, 2013.