Objective: To describe the spectrum of congenital heart disease in a population of children attending a visiting paediatric cardiology clinic.

Methods: We reviewed the clinical records and echocardiograms of children attending a screening clinic that was part of an annual visiting cardiac surgical team.

Results: A total of 519 children were examined between 2002 and 2008. Ages ranged from 1 day to 18 years. Twenty-nine had normal hearts, 77 had rheumatic disease and 64 had postoperative studies. The remaining 349 had a variety of lesions. In decreasing order of frequency they included: ventricular septal defect 39%, tetralogy of Fallot 16%, duct 9%, atrial septal defect 9%, complex 8%, pulmonary stenosis 2.6%, congenital aortic valve disease 2.3%, atrioventricular septal defect 2%, coarctation 1.4% and transposition 1.4%. An assortment of other lesions had a frequency of 1% or less. Aortic valve prolapse occurred in 38% and regurgitation occurred in 24% of all ventricular septal defects. Those with complex lesions tended to have pulmonary outflow obstruction or high pulmonary resistance protecting them from heart failure. Very few duct dependent lesions were seen.

Conclusion: The spectrum of lesions reflects the limited access to tertiary cardiac services. The most common complex lesions are those that allow medium term survival without surgical treatment. Aortic prolapse and regurgitation commonly complicate ventricular septal defects in these children.