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Anthropometric investigations utilizing the classical methods of Martin-Sailer were carried out on 191 Bulgarian children with congenital heart disease. Nineteen measurements of height, width and circumference plus the weight were taken during the course of a cross-sectional growth study. Children with congenital heart disease were found to lag behind normal children in their physical development. The differences between healthy children and those with heart disease increased with increasing age and were more pronounced for weight than for height. Furthermore, not all parts of the body showed the same degree of retardation. The body structure was characterized by a disproportion: the head, neck and shoulder measurements of the children with heart defects were not very different from those in healthy children, while the thorax and the trunk were significantly reduced; this reduction was most pronounced in the pelvis and lower extremities. The antero-posterior diameter of the pelvis was so much reduced that the pelvis could be considered as quite flat. There were indications that this configuration of the pelvis would persist into adulthood with the resulting consequence that females could experience complications in childbirth. This pattern of retardation resulted in sick children who appeared to be younger or more immature than their chronological age. Pubertal development was retarded in these children by one to two years and the span of time during which the secondary sexual characteristics developed was prolonged. Local manifestations were observed in some of the children: voussure, most often in patients with left-to-right shunt, Harrison’s grooves and clubbing of fingers mostly in children with Fallot’s tetralogy and transposition of the large blood vessels.