Pneumonia in Children with Congenital Heart Disease: A Literature Review

Abstract

Pneumonia is a leading cause of morbidity and mortality among children worldwide, particularly in those with Congenital Heart Disease (CHD). CHD causes hemodynamic disturbances and pulmonary congestion, which increase the risk of recurrent pneumonia and exacerbate the severity of infection. This literature review aims to systematically analyze current data on risk factors, clinical manifestations, mortality, morbidity, and clinical outcomes of pneumonia in children with CHD. A narrative review method was used, with literature searches conducted through PubMed and ScienceDirect databases using the keywords “pneumonia,” “congenital heart disease,” and “children” for publications between 2020–2025. Four relevant articles meeting the inclusion criteria were analyzed descriptively. The analysis revealed that the prevalence of CHD among children with pneumonia ranged from 12.5% to 21.3%, predominantly consisting of acyanotic defects such as Ventricular Septal Defect (VSD), Patent Ductus Arteriosus (PDA), and Atrial Septal Defect (ASD). Left to right shunt CHD contributes to chronic pulmonary overcirculation, leading to pulmonary edema, congestive heart failure, and a favorable environment for respiratory infections. Children with CHD have longer hospital stays (more than seven days), a higher risk of ICU admission, and a mortality rate twice as high as children without CHD. In conclusion, CHD is a significant risk factor for the increased incidence and severity of pneumonia in children. Early detection and cardiac screening, especially in recurrent pneumonia cases, are essential to prevent complications and reduce mortality through an appropriate multidisciplinary approach.