Workload of ambulatory activities in a tertiary paediatric cardiac centre.

BACKGROUND: Few data are available on the evolution in the number of referrals and the spectrum and frequency of issues addressed in paediatric cardiac outpatient clinics.

AIM: To assess the volume and range of symptoms and diagnoses in patients, referred to a paediatric cardiac outpatient clinic in an academic hospital setting.

METHODS: Data were collected prospectively over 6 months.

RESULTS: Historical comparison showed that the number of outpatient visits increased from 819 during the first semester of 2004 to 865, 1045 and 1391 during the first semesters of 2005, 2006 and 2007, respectively. During the 6-month study period in 2007, 854/1391 visits concerned patients with known heart disease; the reason for the visit was follow-up of congenital heart disease (n=616 children, 128 adults), arrhythmia (n=91) or acquired heart disease (n=19). During the visit, the decision to perform diagnostic or therapeutic cardiac catheterization or a surgical procedure was taken in 47 cases. Foetal echocardiography was performed in 60 foetuses and was abnormal in 21 cases. Among the other 477 visits, which concerned patients without known heart disease, the most frequent clinical concern was cardiac murmur (n=193) and there were new diagnoses of congenital heart disease (n=28), ventricular dysfunction (n=2) and arrhythmia (n=7).

CONCLUSIONS: The ambulatory paediatric cardiology workload in tertiary academic hospital settings is increasing alarmingly. These data may be helpful in future planning of consultant manpower and in curriculum development for cardiac training of students and residents.