Clinical and Epidemiological Profile of Children Evaluated at a Public Pediatric Cardiology Service in Southern Brazil

Background/Objectives: Congenital heart disease (CHD) is a major cause of congenital morbidity and mortality, but evidence from public pediatric cardiology services in Brazil remains limited. This study aimed to characterize the clinical and epidemiological profile of children and adolescents referred to a public pediatric cardiology service in Southern Brazil, including referral patterns, diagnostic findings, and healthcare utilization, and to explore factors associated with age-appropriate development. Methods: In this cross-sectional study, medical records of patients aged 0–17 years referred to and evaluated at a public university hospital in Rio Grande, Rio Grande do Sul, were retrospectively reviewed. Demographic, referral, clinical, diagnostic, hospitalization, family history, school performance and developmental data were extracted. Groups were compared using the chi-square or Fisher’s exact test. Poisson regression with robust variance estimated prevalence ratios in an exploratory secondary analysis of age-appropriate development. Sensitivity analyses were performed excluding isolated patent foramen ovale, applied a stricter structural CHD definition, restricted the adjusted analysis to patients who underwent echocardiography, and modeled age using clinical categories. Results: Among 263 referred patients, CHD was confirmed in 128 (48.7%); among these, 84% had acyanotic and 16% had cyanotic CHD. Suspected heart disease was the most frequent reason for referral (64%). Echocardiography was performed in all patients with confirmed CHD compared with 24% of those without CHD, and hospitalization was more frequent among patients with confirmed CHD (52% vs. 21%). In the exploratory adjusted analysis, no statistically significant overall association was detected between CHD category and age-appropriate development (p = 0.122). The estimate for cyanotic CHD suggested a lower prevalence than no CHD, but the confidence interval included the null and the estimate was imprecise (adjusted PR 0.745; 95% CI 0.553–1.002). Age at evaluation showed a small inverse association. Sensitivity analyses yielded estimates in the same direction as the primary model, while the overall CHD-category association was statistically significant only in the analysis restricted to patients who underwent echocardiography. Conclusions: Under the record-based operational definition, CHD was confirmed in nearly half of the referred patients, predominantly acyanotic. These findings characterize the clinical and epidemiological profile and healthcare demands of children reaching specialized pediatric cardiology care in southern Brazil and may support improvements in referral pathways and planning of specialized care for patients with CHD.