The technique of fetal echocardiography, with its indications and results in a selected population

1991 ◽  
Vol 1 (2) ◽  
pp. 141-148 ◽  
Author(s):  
Maria J. Maitre Azcárate ◽  
Manuel Quero Jiménez

SummaryOne of the most important contributions of echocardiography to the diagnosis of congenital cardiac malformations is represented by its use in prenatal evaluation. In the present work we discuss the analysis of echocardiographic findings in a preliminary study of the hearts of fetuses in 273 pregnant women. The cases have been divided into three groups. The first group of 169 women was made up of those without a known factor conferring high risk on the pregnancy. The second group of 18 women was comprised of those of suspicions of either arrhythmias or congenitally malformed hearts. The final group of 86 women, consisted of those having had previous children with congenital heart disease. The incidence of pathology in those without risk was 0.5%. In those referred because of suspicion of disease, the incidence was 16.6%, while in those with previous history of children with heart disease, the incidence was 5.8%. Our findings proved the utility of the echocardiogram for the diagnosis of heart malformations prior to birth and confirmed the increased incidence of malformations in fetuses in mothers who had previously produced children with congenital heart disease. The high incidence of cardiac abnormalities in the group referred on the basis of an earlier scan is due to the filter represented by routine echocardiography performed by the obstetricians.

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Vlasta Fesslova ◽  
Jelena Brankovic ◽  
Faustina Lalatta ◽  
Laura Villa ◽  
Valerio Meli ◽  
...  

Objectives. To evaluate the recurrence of congenital heart disease (CHD) in pregnant women with familial risk who had been referred for fetal echocardiography.Material and Methods. 1634 pregnancies from 1483 women with familial history of CHD in one or more relatives were studied. Fetal cardiologic diagnosis was compared with postnatal findings at 6 months or at autopsy.Results. Total recurrence rate of CHD was 3.98%, 4.06% in single familial risk, 2.9% in double, and 5% in multiple risk. It was 3.5% in case of one previously affected child; 4.5% with 2 children; 5.2% with the mother alone affected and 7,5% with father alone affected and 3.5% with a single distant relative. Exact concordance of CHD was found in 21.5% and a partial concordance in 20% of cases.Conclusions. Our data show a higher recurrence rate of CHD than previously published data and high relative risk ratios compared to normal population.


2017 ◽  
Vol 34 (12) ◽  
pp. 1760-1767 ◽  
Author(s):  
Dev Maulik ◽  
Navin C. Nanda ◽  
Devika Maulik ◽  
Gustavo Vilchez

2013 ◽  
Vol 53 (3) ◽  
pp. 173
Author(s):  
Sri Endah Rahayuningsih

Background Congenital heart disease (CHD) may occur inseveral members of a family. Studies have shown that familialgenetic factor play a role in CHD.Objective To identify familial recurrences of CHD in familieswith at least one member treated for CHD in Dr. Hasan SadikinHospital, Bandung Indonesia.Methods In this descriptive study, subjects were CHD patientshospitalized or treated from January 2005 to December 2011. Weconstructed family pedigrees for five families.Results During the study period, there were 1,779 patients withCHD. We found 5 families with 12 familial CHD cases, consistingof 8 boys and 4 girls. Defects observed in these 12 patients weretetralogy of Fallot, transposition of the great arteries, persistentductus arteriosus, ventricular septa! defect, tricuspid atresia,pulmonary stenos is, and dilated cardiomyopathy. Persistent ductusarteriosus was the most frequently observed defect (4 out of 12subjects) . None of the families had a history of consanguinity. Therecurrence risk of CHD among siblings was calculated to be 0.67%,and the recurrence risk ofCHD among cousins was 0.16%.Conclusion Familial CHD may indicate the need for geneticcounseling and further pedigree analysis.


2017 ◽  
Vol 5 (1) ◽  
pp. 53-56
Author(s):  
Rahul Regi Abraham ◽  
Rahul Regi Abraham

Background: Patient diagnosed with double inlet left ventricle (prevalent in 5 – 10 in 100,000 newborns) complicated with Eisenmenger syndrome had a median survival age of 14 years without corrective surgery. Congenital heart disease such as this is usually treated by multiple surgeries during early childhood. A surgically uncorrected case in adults is not of common occurrence. Further, generalized itching after coming in contact with water (aquagenic pruritis) presented an interesting conundrum to treat. Case: A 29-year-old patient in India presented at a primary health care center with a history of difficulty breathing and discoloration of extremities since birth. He also gave a history of itching which commonly occurred after taking bath, hemoptysis and history of turning blue in color after birth. Patient had received no treatment besides regular phlebotomies. On examination, there was grade IV clubbing and conjunctival congestion. Cardiovascular examination revealed an enlarged heart, heaving apex beat and a pan-systolic murmur. A provisional diagnosis of a congenital cyanotic heart disease was made. Investigations revealed hemoglobin of 16.8g/dl. X–ray and electrocardiogram showed hypertrophy of the ventricles. An echocardiogram showed double inlet left ventricle with L-malposed vessels but without pulmonary stenosis. A final diagnosis of congenital heart disease; double inlet left ventricle, L-malposed vessels without pulmonary stenosis, Eisenmenger Syndrome and absolute erythrocytosis was made. Patient was advised for further management with a cardiologist in a tertiary center but the patient did not follow up. Conclusion: Unlike in high-income countries where most congenital heart diseases are detected and dealt with at birth whereas low-and middle-income nations often have to deal with cases that present much later and should often be included in the differential diagnosis. Inability to follow up cases, centers that are poorly equipped and lack of facilities for investigations, patient’s lack of medical awareness, and financial restrictions are major barriers to providing optimal treatment.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Wagih m Zayed ◽  
Neha Bansal ◽  
Snehal R Patel ◽  
Jacqueline M Lamour ◽  
Daniel J GOLDSTEIN ◽  
...  

Introduction: Heart failure (HF) is the leading cause of death in adults with congenital heart disease (ACHD). Heart transplant (HT) is one of the few options for the treatment of advanced HF in this growing population. In October 2018, the United Network for Organ Sharing (UNOS) implemented a change in organ allocation criteria. The effect of this change on outcomes in ACHD patients (pts) after listing and transplant has not been evaluated. Hypothesis: Change in organ allocation criteria negatively impacts outcomes in ACHD patients. Methods: Data from the Scientific Registry of Transplant Recipients in pts age > 18 years old listed for HT between Oct. 2016 and 0ct. 2019 and followed through March 2020 were analyzed. Pts were grouped by diagnosis (ACHD and non-ACHD) and by the time of listing (pre- and post-change in allocation criteria). Differences in comorbidities, outcomes while listed, and 1-year Kaplan Meier survival post-HT were compared among groups. For comparison, post-change criteria (status 1-6) were equated to pre-change criteria (status 1A, 1B, 2). Results: Over 3 years, 11,931 patients were listed for HT; 459 had a primary diagnosis of ACHD. ACHD was present in 279/7942 pts listed in the 2 years pre-change and 180/3989 pts in the year post-change. ACHD pts listed post-change were less likely to have a history of cardiac surgery (88% vs. 79%, p=0.01) and more likely to have an abnormal BMI (p=0.015) than ACHD pts pre-change. Post-change, ACHD pts were listed at a higher priority status compared to pre-change ACHD. (Figure). The proportion of pts transplanted with ACHD increased slightly pre- and post-change (3.7% vs. 4.1%). There was no difference in 1-year survival in ACHD pts transplanted pre- and post-change (Figure). Conclusions: Recent changes to the UNOS organ allocation policy increased the proportion of ACHD patients transplanted with no change in early post-HT survival.


PEDIATRICS ◽  
1968 ◽  
Vol 41 (1) ◽  
pp. 123-129
Author(s):  
Blanche P. Alter ◽  
Emily E. Czapek ◽  
Richard D. Rowe

Sweating was found to be increased in children with congenital heart disease who had a propensity to congestive heart failure, e.g., children with endocardial fibroelastosis or large or moderate sized left-to-right shunts. This was suggested in a review of cardiac clinic records of 220 patients and was supported by the results of pilocarpine sweat tests which were performed on 34 cardiac patients. By history and by measurement of the amount of sweat produced, children with a history of or tendency toward heart failure could be predicted though patients did not need to be in failure when tested. Contrary to previous opinion, the left-to-right shunt was not in itself sufficient to cause the child to sweat. The shunt had to be large enough to be associated with failure at some time. It is suggested that the pilocarpine sweat test might actually be useful as an aid in predicting a child's potential for heart failure. Several theories regarding the mechanism of sweating in these situations are discussed.


PEDIATRICS ◽  
1969 ◽  
Vol 43 (5) ◽  
pp. 757-758
Author(s):  
A. M. R.

Respiratory distress is a very frequent symptom in infants with acyanotic congenital heart disease. Some of the specific physiological and pathological mechanisms involved in this association have been presented in Pediatrics.1 That communication stressed the frequency with which cardiac failure associated with large left-to-right shunts presents with respiratory distress, often misinterpreted as being due to pulmonary disease. It has, however, also been long recognized that there is a high incidence of pulmonary infection in infants with large left-to-right shunt lesions. The cause of these frequent infections in such patients is not yet evident, but a possible explanation now seems to be suggested from recent observations at autopsy.


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