Pattern of un-operated Grown Up Congenital Heart (GUCH) patients presenting to a Tertiary Care Cardiac Institute of Punjab

Pattern of GUCH in Pakistan

  • Abdul Razzaq Mughal Faisalabad Institute of Cardiology
  • Rubina Tousif Children Hospital Faisalabad
  • Asif Rashid Alamgir Faisalabad Institute of Cardiology
  • Anjum Jalal Faisalabad Institute of Cardiology
Keywords: Congenital Heart Disease, Grown-up congenital heart disease, Morbidity


Objectives: To identify the pattern of un-operated grown up congenital heart defects at our tertiary care cardiac institute.

Methods: This is a prospective observational study. All un-operated GUCH patients who presented to Faisalabad Institute of Cardiology (FIC) from May 2017 to 30th July 2017 were enrolled. Diagnosis was established on Transthoracic Echocardiography done by dedicated pediatric cardiologist at FIC. The mode of presentation, presenting complaints, type, severity, complications and co-morbid conditions of CHD were recorded.

Results: A total of 200 consecutive patients were enrolled. Mean age was 29.92 ± 11.21 years. There were 104 females (52%) and 96 males (48%). Majority of patients presented in Out-Patient Department (84%) while 16% presented in emergency (n=32). The most common cardiac anomalies were: Atrial Septal Defect (ASD) 41.5% (83), Tetralogy of Fallots (TOF) 42 (21%), Ventricular Septal Defect (VSD) 28 (14%) and Patent ductus arteriosus (PDA) 8 % (16). Cyanotic CHD was present in 43% (86) while TOF was the most common of it. The disease was of moderate complexity in 77.5% patients. Certain complications like Pulmonary hypertension 69(34.5%), Eisenmenger 33(16.5%), Rhythm disturbances 15 (7.5%), Infective endocarditis 5(2.5%) were also present along with co-morbid conditions like coronary artery disease (1.5% and systemic hypertension (2.5%). Dyspnea on exertion (59.5%) followed by cyanosis (41%) were the most common presenting complaints. The most common reason for hospital admission was cardiac signs and symptoms (19.5%) followed by cardiac catheterization (10.5%).

Conclusion: The ASD, TOF, VSD and PDA remain the most common CHD in descending order while pulmonary hypertension, Eisenmenger, heart failure, arrhythmias, infective endocarditis and stroke were the common complications of CHD at this particular age.


How to cite this:
Mughal AR, Tousif R, Alamgir AR, Jalal A. Pattern of un-operated Grown Up Congenital Heart (GUCH) patients presenting to a Tertiary Care Cardiac Institute of Punjab. Pak J Med Sci. 2019;35(4):1066-1071. doi:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Author Biographies

Abdul Razzaq Mughal, Faisalabad Institute of Cardiology

Assistant Professor of Paediatric Cardiology

Faisalabad Institute of Cardiology, Faisalabad. 

Rubina Tousif, Children Hospital Faisalabad

Senior Registrar

Department of Paediatric Cardiology

Children Hospital, Faisalabad

Asif Rashid Alamgir, Faisalabad Institute of Cardiology


Department of Cardiac Anesthesia

Faisalabad Institute of Cardiology


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