Discussion
It is well known that malnutrition accompanies
and contributes to morbidity in CHD. Controversy
exists regarding the relative roles of low
caloric intake, type of cardiac lesion, malabsorption,
and hypermetabolism.1–4 Patients
with CHD and cyanosis, pulmonary hypertension,
and congestive heart failure appear to
have an increased prevalence of growth failure
and malnutrition.1 4–6 Optimising nutritional
status improves surgical outcome and contributes
to reduced morbidity. In a large survey of
890 children with various CHD, 55% were
below the 16th centile for height, 52% were
below the 16th centile for weight, and 27%
were below the 3rd centile for both length and
weight.7 In our study malnutrition appears to
be more prevalent and more severe, as 65% of
the children were below the 5th centile for
weight, and 41% were below the 5th centile for
both weight and height. Fifty six of 89 patients
(63%) were underweight for their length. This
might have been because most of the patients
referred to our hospital had severe cardiac
lesions and were from families of a low
socioeconomic level. As shown in table 3
chronic malnutrition, which aVects both
weight and length, is also an important
problem in CHD.