Adolescents and adults with congenital heart diseases in Oman

The aim of our study was to examine the spectrum, demographics, and mortality rate among adolescents and adults with congenital heart diseases [CHD] in Oman. Data was collected retrospectively from the Royal Hospital, Muscat, electronic health records for all patients with a diagnosis of CHD aged 13 years and above. Data was analyzed according to the type of CHD and in-hospital mortality was assessed using Kaplan-Meier survival analysis. A total of 600 patients with CHD were identified, among them 145 [24%] were aged 18 years or below. The median age was 24 years. The majority of patients had a simple form of CHD. Atrial and ventricular septal defects together constituted 62.8% of congenital heart diseases. Most patients were clustered in Muscat [32%] and the Batinah regions [31.1%] of Oman. Patients with tetralogy of Fallot and Fontan had shorter survival time than recorded in the published literature. Mostly simple forms of CHD in younger patients was observed. The survival rate was significantly shortened in more complex lesions compared to simple lesions. A national data registry for CHD is needed to address the morbidities and mortality associated with the disease

Coarctation of the aorta, known yet can be missed

The clinical presentation of coarctation of aorta [CoA] is well known; however, it is the most common congenital heart disease in the newborn period to be missed, with significant mortality and morbidity associated with missing the diagnosis. We report a 20-day-old newborn boy who presented with congestive heart failure and weak femoral pulses. Chest X-ray [CXR] showed cardiomegaly and pulmonary edema and electrocardiography [ECG] showed extreme right axis deviation and absent left ventricular forces in the left precordial leads. Based on these, clinical suspicion of coarctation of aorta was made and confirmed by echocardiography. After initial stabilization with prostaglandin E2 infusion, child underwent urgent coarctation of aorta repair with uneventful post-operative course. High index of suspicion for coarctation of aorta in a newborn with such presentation is required and urgent referral to Pediatric Cardiology and cardiac surgery center is mandatory to reduce the morbidity and mortality associated with missing the diagnosis