Validation of the accuracy of handheld echocardiography for diagnosis of congenital heart disease.

BACKGROUND

Handheld echocardiography (HHE) has been increasingly used for rheumatic heart disease screening and in adult emergency room settings.

AIMS: This study aimed to validate the accuracy of HHE in the diagnosis of congenital heart disease (CHD).

SETTINGS AND DESIGN METHODOLOGY: This is a prospective study carried out at three pediatric cardiology outpatient clinics in Khartoum, Sudan.All patients with suspected CHD were evaluated by clinical examination followed by HHE, performed using a modified segmental approach. Then, a complete study was performed using a standard echocardiography machine. The results were then compared using appropriate statistical tools.

RESULTS

A total of eighty cases were included with the following diagnoses either in isolation or combination: ventricular septal defect (n = 23), atrial septal defect (n = 10), pulmonary stenosis (n = 7), tetralogy of Fallot (n = 7), patent ductus arteriosus (n = 6), atrioventricular septal defect (n = 6), transposition of the great arteries (n = 6), and other diagnoses (n = 15). Agreement between HHE and SE was excellent both for visualizing heart segments (κ =77%-100% with a mean of 92.9%) and for diagnosis of CHD (κ =66%-100% with a mean of 91.7%). The sensitivity of HHE was 69.2%-100% (mean = 90.2%) and specificity was 98.5%-100% (mean = 99.3%).

CONCLUSION

This study supports extending the utility of HHE in children for screening of CHD in addition to its current role in rheumatic heart disease screening.