CLINICAL FEATURES AND STRUCTURE OF CASES IN CHILDREN WITH CONGENITAL HEART DISEASE

Abstract

Relevance. Congenital heart defects (CHD) represent the most common group of congenital developmental anomalies in children and remain one of the leading causes of neonatal and infant mortality. According to global statistics, the prevalence of CHD ranges from 6 to 10 cases per 1,000 live births. With the current advances in cardiac surgery and neonatology, timely diagnosis of clinical, laboratory, and instrumental parameters in children with CHD is of critical importance for determining prognosis, selecting optimal treatment strategies, and preventing complications. The purpose of the study. To assess the clinical manifestations, physical development, laboratory, and instrumental indicators in young children with congenital heart defects of varying severity. Materials and methods of the study. The study included 49 children with congenital heart defects who underwent examination and treatment at the Department of Cardiac Surgery, Tashkent Pediatric Medical Institute. The age of the patients ranged from several weeks to 3 years. All children underwent a comprehensive clinical and instrumental assessment, including medical history collection, physical examination, anthropometric measurements (height, weight, body mass index), laboratory tests (complete blood count, biochemical analysis, hemoglobin level, protein and electrolyte parameters), and instrumental methods such as electrocardiography (ECG), echocardiography (EchoCG), chest radiography, and abdominal ultrasound when indicated. The severity of heart failure was determined according to the Ross classification (Ross, 1992). Research results. The most common CHD among the examined children was ventricular septal defect (VSD), identified in 46.9% of patients. Ventricular septal defect and patent ductus arteriosus (PDA) were the next most frequent. Isolated defects were found in 51% of cases, while combined defects were observed in 47%, indicating a high prevalence of complex cardiac malformations in early childhood. Pulmonary hypertension (PH) was diagnosed in 57.1% of children, mainly in those with significant shunts and combined defects, underscoring the importance of early detection of elevated pulmonary artery pressure. Growth retardation was noted in most boys, likely associated with chronic hypoxia and reduced exercise tolerance. All patients exhibited anemia, reflecting impaired oxygen transport and compensatory adaptation to hypoxia. Congestive pulmonary changes were identified in 26.5% of cases, while gastrointestinal and urinary tract disorders were observed in 10.2% of children, indicating a systemic impact of cardiac pathology on somatic health. Conclusion. Young children with congenital heart defects demonstrate marked impairments in physical development, anemia, pulmonary hypertension, and a high frequency of combined cardiac defects. The degree of heart failure does not always correlate with the age at diagnosis, emphasizing the importance of a comprehensive approach to examination and follow-up. Timely detection of clinical, laboratory, and instrumental abnormalities helps to determine disease prognosis, plan surgical correction, and reduce the risk of complications.