Pediatric tele-echocardiography in the diagnosis of congenital heart diseases in a regional referral hospital in eastern Bhutan

Abstract

Introduction: Congenital Heart Diseases are the commonest birth defects and the most common reason for out-country referral of pediatric patients in Bhutan.Without any qualified pediatric cardiologists in the country, early diagnosis and appropriate care of pediatric cardiac patients is often delayed or inappropriate. Collaboration through telemedicine between general pediatrician and pediatric cardiologist can improve the diagnosis of congenital heart diseases in Bhutan.

Methods: Pediatric patients clinically suspected to have congenital heart diseases underwent Echocardiography at Mongar regional referral hospital. The Echocardiograms, performed by general pediatrician, were e-mailed to Pediatric Cardiologist working in UK, who gave the diagnosis after viewing the Echo-loops. This was compared with the final diagnosis made at tertiary cardiac centre in India.

Results: 30 echocardiograms performed by general pediatrician at Mongar Hospital in eastern Bhutan were mailed to Pediatric Cardiologist working in UK. Of the thirty cases, 20 required no immediate referral and were put on medications and follow up plans. 10 of the 30 cases required
early referral to tertiary care hospital in India. There was excellent concordance between the diagnosis made through tele-echocardiology and the final diagnosis made at tertiary cardiac centre.

Conclusions: Tele-echocardiography between a general Pediatrician and a Pediatric Cardiologist can greatly enhance the diagnosis of congenital heart diseases in children.