Evaluation of congenital heart disease frequency in children with recurrent or persistent pneumonia

Purpose:. Pneumonia is one of the leading causes of death in young children and infants, especially in developing countries. Recurrent pneumonia (RP) is defined as two pneumonia episodes in a year or at least three episodes in a lifetime. And persistent pneumonia is defined by clinical and radiological findings that last more than a month despite at least ten days of antibiotic treatment. There are numerous pathologies involved in the etiology of repetitive/persistent pneumonia. This study aims to determine the underlying congenital heart disease (CHD) in recurrent or persistent pneumonia and to present the data from our region to the literature. Materials and Methods: A total of 102 patients between the ages of 0-18 whose repetitive/persistent pneumonia were tracked and treated in Dicle University Medical Faculty Hospital's Pediatric Cardiology and Pediatric Pulmonology outpatient clinics between June 2019 and February 2021 were included in our study. Patients' ages, body weights, number of pneumonia attacks, physical examination findings, echocardiographic evaluations, laboratory findings, lung imaging were recorded. The data obtained were evaluated statistically. Findings: Of the patients whose ages were between 3 and 180 months (mean 24.36 ± 32 months), 69 (67.6%) were male. While the entire patient group met the criteria for recurrent pneumonia, 55 patients (54%) also met the criteria for persistent pneumonia. CHD was detected in 22 patients (21.5%). The most common CHD was isolated Atrial Septal Defect with 8 patients (7.8%), followed by isolated Ventricular Septal Defect with 5 patients (4.9%). In 8 patients (7.8%) with CHD, TP etiology was attributed to cardiac pathology, and congenital cardiac anomaly was found in 13 (23.6%) patients with persistent pneumonia. In 6 patients (10.9%), PPE was cited as the etiological cause. Conclusion: In our research, CHD was found in 7.8% of the study group in the etiology of the patients with RP; and together with CHDs that do not have an etiological significance for RP, congenital heart anomalies were detected in 21.5% of the patients. In patients with persistent pneumonia, the rate of CHD was found to be 23.6%. CHD was identified as the etiological cause for persistent pneumonia in 10.7% of the patient group. Body weight Z-scores of the patients with CHD was found to be statistically significantly lower than the patient group without CHD (p: 0.04). It was observed that the incidence of CHD in girls with recurrent pneumonia was high in comparison with the incidence of CHD in boys with RP, and this result was statistically significant (p:0.05). A study examining gender, growth retardation, symptoms and complaints specifically for CHD patients with recurrent and persistent pneumonia has not been published before. Our findings need to be supported by new studies. KEYWORDS: Recurrent Pneumonia, Child, Congenital Heart Disease