Analysis of Congenital Heart Defects in Neonates: A Tertiary Care Hospital’s Perspective from Karachi

Objective: To determine the frequency and distribution of congenital heart defects (CHD) among neonates presenting with clinical suspicion of CHD at a tertiary care hospital. Methodology: A cross-sectional study was conducted in the Neonatal Intensive Care Unit (NICU) of the National Institute of Child Health (NICH), Karachi, Pakistan, from January 2023 to June 2023. A total of 100 neonates (aged 0–28 days) meeting the inclusion criteria were enrolled. Following a detailed clinical history, physical examination, and systemic assessment, neonates exhibiting signs and symptoms suggestive of CHD underwent echocardiography by a pediatric cardiologist for definitive diagnosis. CHD cases were classified as atrial septal defect (ASD), ventricular septal defect (VSD), tetralogy of Fallot (TOF), patent ductus arteriosus (PDA), pulmonary stenosis (PS), or tricuspid atresia (TA). Results: Among the 100 neonates with suspected CHD, 52% were male and 48% were female, with a mean age of 9.7 days (SD ±7.3). Congenital heart defects were confirmed in 84 neonates (84%), while 16 (16%) had normal cardiac findings. Female neonates exhibited a slightly higher prevalence of CHD. The most common defect was PDA (58 neonates, 61.7%), followed by VSD (28 neonates, 29.8%), ASD (9 neonates, 9.6%), TOF (8 neonates, 8.5%), PS (6 neonates, 6.4%), and TA (4 neonates, 4.3%). Conclusion: The study demonstrates a high prevalence of CHD among neonates with clinical suspicion of cardiac anomalies, underscoring the need for early diagnostic evaluation in this population.