The accuracy of chest radiographs in the detection of congenital heart disease and in the diagnosis of specific congenital cardiac lesions

ABSTRACT Complex congenital heart diseases (CHD) often present as multiple cardiac lesions. The presence of one anomaly should stimulate the physician to perform a comprehensive assessment and look for other associated anomalies.1 Multimodal imaging may be necessary to diagnose such associated lesions as single imaging may occasionally miss them. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) are complimentary to each other. Routine use of TEE during intraoperative period may help us to refine diagnosis, detect the missing components and guide effective surgical repair. We present one such case where diagnosis and management were optimized by multimodal imaging. How to cite this article Kumar B, Madhavan JS, Puri GD, Rana SS. Role of TEE in Improving Diagnostic Accuracy of Congenital Heart Disease. J Perioper Echocardiogr 2014;2(2):68-70.

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Pattern and frequency of pediatric congenital heart disease at the Cardiac Research Institute of Kabul Medical University, Afghanistan

Paediatrica Indonesiana ◽

10.14238/pi58.3.2018.106-9 ◽

2018 ◽

Vol 58 (3) ◽

pp. 106-9

Author(s):

Abdul Muhib Sharifi

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Atrial Septal Defect ◽

Tetralogy Of Fallot ◽

Congenital Heart ◽

Septal Defect ◽

Heart Defects ◽

Cardiac Lesions ◽

Medical University ◽

Research Institute

Background Congenital heart disease (CHD) is the most common birth defect, with incidence of 0.7-0.9 live birth; it increases to 2-6% if first degree relative is affected. In Afghanistan majority of births take place at home and routine screening of neonates is not common, so true birth prevalence of CHD cannot be possibly calculated. Therefore, true prevalence of CHD in our population is unknown. Objective To verify the current pattern and frequency distribution of congenital heart disease (CHD) at the Cardiac Research Institute of Kabul Medical University. Methods This retrospective study was conducted in children aged 0-14 years, who underwent echocardiography for possible congenital heart disease from January 2015 to December 2016. Results Of 560 patients who underwent echocardiography, 392(70%) had cardiac lesions. Congenital cardiac lesions were found in 235 (60% of those with lesions) patients, while 157 (40%) patients had rheumatic heart disease. Patients with CHD were further subdivided into acyanotic and cyanotic groups. The majority of acyanotic group had isolated atrial septal defect (55%) while the most common lesion in the cyanotic group was Tetralogy of Fallot (42%). Conclusion Congenital heart defects are the most common heart disease in the pediatric population presenting at the Cardiac Research Institute of Kabul Medical University. Atrial septal defect (ASD) was the most common acyanotic defect, while Tetralogy of Fallot (ToF) is the most common cyanotic defect.

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Chest radiographic findings in children with asplenia syndrome

Asian Biomedicine ◽

10.2478/abm-2010-0074 ◽

2010 ◽

Vol 4 (4) ◽

pp. 585-594

Author(s):

Panruethai Trinavarat ◽

Kullana Tantiprawan ◽

Apichai Khongphatthanayothin

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Heart Diseases ◽

Pulmonary Atresia ◽

Chest Radiographs ◽

Pulmonary Vasculature ◽

Ipsilateral Side ◽

Radiographic Findings ◽

Asplenia Syndrome

Abstract Background: Early diagnosis of asplenia syndrome is important because prophylactic antibiotic and proper vaccination will prevent serious infection. Most children with asplenia syndrome present with symptoms of congenital heart disease. Chest X-ray is usually the first line imaging modality. Objective: Define useful findings in chest radiograph that could suggest the diagnosis of asplenia syndrome. Methods: Chest radiographs of pediatric patients who had asplenia syndrome diagnosed between January 1, 2002 and June 30, 2008 in a single institute were retrospectively reviewed for the positions of the visceral organs in the chest and abdomen. Results: Three hundred seventy one chest radiographs of 30 patients were reviewed. The mean age at diagnosis was 3 years old. Asplenia was diagnosed by ultrasound in 27 patients, by CT scan in two patients, and by damaged red blood cell scintigraphy in one patient. Six important findings detected from chest radiographs were, 1) bilateral minor fissures, 16 cases (53%), 2) bilateral eparterial bronchi, 16 cases (53%), 3) ipsilateral side of stomach and liver, 12 cases (40%), 4) ipsilateral side of minor fissure or eparterial bronchus and stomach, 10 cases (33%), 5) symmetrical transverse lie of the liver, nine cases (30%), and 6) contralateral side of minor fissure or eparterial bronchus and the liver in seven cases (23%). All except two patients (93%) had at least one of the above findings. All patients had congenital heart diseases. Most of the heart diseases were pulmonary atresia or pulmonary stenosis (88%) and single ventricle (85%). Conclusion: Chest radiographs have high sensitivity in suggesting the diagnosis of asplenia syndrome, when detecting one or more of the above findings, particular in patients with congenital heart disease and decreased pulmonary vasculature.

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Imaging Congenital Heart Disease in the Perioperative Period using Transesophageal Echocardiography

Journal of Perioperative Echocardiography ◽

10.5005/jp-journals-10034-1015 ◽

2014 ◽

Vol 2 (1) ◽

pp. 10-28

Author(s):

Manchula Navaratham ◽

Rajesh Punn ◽

Theresa A Tacy

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Transesophageal Echocardiography ◽

Congenital Heart ◽

Systematic Approach ◽

Standard Of Care ◽

Perioperative Period ◽

The Usa ◽

Cardiac Lesions ◽

Heart Lesions

ABSTRACT Intraoperative transesophageal echocardiography (TEE) for pediatric congenital heart disease has become a standard of care in most institutions in the USA and across Europe. Advances in technology have facilitated the safe use of this tool in patients as small as 2.5 kg and have proved invaluable in guiding surgical repair of congenital cardiac lesions as well as guiding anesthesia management for cardiac and noncardiac procedures. This article describes a systematic approach to image acquisition in children with congenital heart disease (CHD). Specific congenital heart lesions are also described with an emphasis on intraoperative TEE data acquisition and analysis. How to cite this article Navaratham M, Punn R, Tacy TA. Imaging Congenital Heart Disease in the Perioperative Period using Transesophageal Echocardiography. J Perioper Echocardiogr 2014;2(1):10-28.

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Vectorcardiography in Congenital Heart Disease: A Method for Estimating Severity, by R. Curtis Ellison, M.D., and Norma J. Restieaux, M.B., Ch.B., F.R.A.C.P., M.R.C.P. (London) with a forward by Alexander S. Nadas, M.D. Philadelphia/London/Toronto: W. B. Saunders Company, 1972, 209 pp., $13.50

PEDIATRICS ◽

10.1542/peds.52.4.631a ◽

1973 ◽

Vol 52 (4) ◽

pp. 631-631

Author(s):

Catherine A. Neill

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Aortic Stenosis ◽

Congenital Heart ◽

Reference Book ◽

Special Interests ◽

Congenital Lesions ◽

Good Review ◽

Cardiac Lesions ◽

Noninvasive Assessment

This beautifully produced book not only shows excellent examples of specific congenital lesions and discusses them in an erudite manner, but also refers to the literature in a comprehensive way. It, therefore, will become a necessary reference book for anyone working in the field of the noninvasive assessment of severity of congenital cardiac lesions. As might be expected from the special interests of the Boston group, the chapter on aortic stenosis is outstanding and provides excellent examples and a good review of the problem.

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Tetralogy of Fallot

10.1093/med/9780199764495.003.0032 ◽

2013 ◽

Author(s):

Renee Nierman Kreeger ◽

James P Spaeth

Keyword(s):

Congenital Heart Disease ◽

Cardiac Surgery ◽

Heart Disease ◽

Congenital Malformations ◽

Congenital Heart ◽

High Likelihood ◽

Pediatric Anesthesiologist ◽

Cardiac Procedures ◽

Definitive Repair ◽

Cardiac Lesions

Patients with congenital heart disease are frequently encountered by the pediatric anesthesiologist for non-cardiac surgery. Fortunately, the majority of these patients have already undergone definitive repair of their cardiac lesions and can often be managed using traditional anesthetic methods. However, given the known association of congenital heart disease with other congenital malformations and syndromes, there is a relatively high likelihood that a pediatric anesthesiologist will encounter a situation involving a child with an unrepaired lesion. With the reported increased mortality rate for patients with complex cardiac lesions undergoing non-cardiac procedures (see Chapter 30), an understanding of the pathophysiology and anatomy, as well as the potential effects of the anesthetic medications and techniques chosen, is paramount to their successful care.

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Aminoterminal Pro B-Type Natriuretic Peptide (NT-proBNP) Levels for Monitoring Interventions in Paediatric Cardiac Patients with Stenotic Lesions

International Journal of Pediatrics ◽

10.1155/2009/241376 ◽

2009 ◽

Vol 2009 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Eva Welisch ◽

Knut Kleesiek ◽

Nikolaus Haas ◽

Kambiz Norozi ◽

Ralf Rauch ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Cardiac Disease ◽

Congenital Heart ◽

Clinical Status ◽

Reference Value ◽

Cardiac Lesions ◽

Stenotic Lesions ◽

Echocardiographic Findings ◽

Compromised Patients

Background.Serum concentration of NT-proBNP correlates well with the severity of cardiac disease in adults. Few studies have been performed on the applicability of NT-proBNP for monitoring children with congenital heart disease.Objective.To assess the potential of NT-proBNP for monitoring the success of interventions in children with stenotic cardiac lesions.Methods.NT-proBNP was measured in 42 children aged 1 day to 17 years (y) before and 6 to 12 weeks after surgical or interventional correction of obstructive lesions of the heart. Comparison is made with the clinical status and echocardiographic data of the child.Results.NT-proBNP levels (median 280, range 10–263,000 pg/mL) were above the reference value in all but 6 patients (pts) prior to the intervention. Higher levels were found in more compromised patients. The 35 children with clinical improvement after the procedure showed a decline of their NT-proBNP level in all but 4 patients, whose levels remained unchanged. Five patients with unchanged gradients despite a therapeutic intervention also demonstrated unchanged NT-proBNP levels after the intervention. Thus, the success rate of the procedure correlated well to clinical and echocardiographic findings.Conclusion.NT-proBNP can be used to assess the efficiency of an intervention.

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