Comprehensive dental evaluation of children with congenital or acquired heart disease

2012 ◽  
Vol 23 (5) ◽  
pp. 705-710 ◽  
Author(s):  
Kenan Cantekin ◽  
Isin Cantekin ◽  
Yasemin Torun
Keyword(s):  
Heart Disease ◽  
Children And Adolescents ◽  
Oral Hygiene ◽  
Cardiac Disease ◽  
Heart Diseases ◽  
Treatment Plan ◽  
Caries Experience ◽  
Univentricular Heart ◽  
Healthy Children ◽  
Acquired Heart Disease

AbstractObjectiveThe aims of this case–control study were to (a) compare the caries experience and oral hygiene, and (b) quantify the persistence of a delay in the dental age in children with cardiac disease and a group of healthy children.Methods and MaterialsThe study population comprised a group of 268 3- to 16-year-old children and adolescents with a cardiac disease and a group of 268 age- and sex-matched healthy children and adolescents. Specifically, the decayed, missed, and filled teeth indices, simplified oral hygiene index, and the dental ages of the two groups of children were calculated and then compared.ResultsAlthough the oral health of the children with either a congenital or an acquired heart disease was the same as that of the healthy children, there were significant differences in the decayed, missed, and filled teeth indices. Dental ages of the children with a congenital heart disease were significantly lower than those of healthy children. The findings showed that complex univentricular heart diseases had the highest negative impact on dental development (−1.1), followed by complex biventricular (−0.9), simple surgical (−0.5), and mild (−0.4) heart disease patients.ConclusionOnce thorough knowledge of the child's cardiac status is gained, a definitive dental treatment plan for the child with a cardiac disease can be established.

New Standards for the Bruce Treadmill Protocol in Children and Adolescents

2001 ◽  
Vol 13 (4) ◽  
pp. 392-401 ◽  
Author(s):  
Hans U. Wessel ◽  
Janette F. Strasburger ◽  
Brett M. Mitchell
Keyword(s):  
Heart Rate ◽  
Heart Disease ◽  
Body Size ◽  
Children And Adolescents ◽  
Age Groups ◽  
Exercise Heart Rate ◽  
Regression Equations ◽  
Asymptomatic Children ◽  
Acquired Heart Disease ◽  
Males And Females

We have developed normal standards for the Bruce exercise (EX) protocol since a review of 875 studies in patients with congenital or acquired heart disease showed that only 5.1% achieved the predicted 50th percentile for EX time of the standards reported by Cumming, Everatt, and Hastman (Am. J Cardiol 41:69, 1978). Our data are based on 160 males and 103 females, age 4–18 years who met the following criteria: trivial or no heart disease, maximal effort, maximal EX heart rate (HR) > 180 beats/min, and normal resting and EX ECG without arrhythmia. The ECG was monitored continuously and HR computed from the ECG and the end of each minute of EX. Comparison with the predicted data of Cumming et al. for each age group by stage showed essentially identical submaximal EX heart rates but slightly lower maximal HR (–2%), which averaged 197 beats per minute in males and females. EX times were on average 15% lower than the predicted 50th percentile for most age groups in males and females. We developed regression equations, which predict exercise time from age and body size or age, body size and 2nd stage exercise heart rate. They better reflect the capabilities of untrained, asymptomatic children and adolescents seen in our laboratory in the 1990s than the Canadian data of 1978.

scholarly journals Study of spectrum of cardiac disease complicating pregnancy and the maternal and foetal outcome

2019 ◽  
Vol 8 (12) ◽  
pp. 4803
Author(s):  
Sudha R. ◽  
Anjali R.
Keyword(s):  
Heart Disease ◽  
Pregnant Women ◽  
Cardiac Disease ◽  
Heart Diseases ◽  
Cardiac Complications ◽  
Team Approach ◽  
Maternal Deaths ◽  
Neonatal Deaths ◽  
Foetal Outcome ◽  
Grade Iii

Background: Heart diseases are the most important non obstetrical causes of maternal deaths during pregnancy, accounting for almost 10% of maternal deaths. They complicate 1-3% of all pregnancies.Methods: The study was conducted at Cheluvamba Hospital from January 2015 till July 2016. All pregnant women with cardiac disease were included in the study. Pregnant women with cardiac disease were followed up during antenatal period, evaluated and maternal and foetal outcome was studied.Results: Total number of deliveries in the one and half year study period was 18,803 cases and the total number of women with cardiac disease was 90. Most of the subjects belonged to NYHA grade I and II (95.5%), whereas NYHA grade III and IV constituted only 4.4% of cases. Rheumatic heart disease was the principal cardiac lesion (62.22%) among the pregnancies, while congenital heart disease (33.33%) was the second most common cause. 16.7% had cardiac complications and there were 2(2.22%) maternal mortality. 91.86% were live births with 5.88% IUDs and 2.35% neonatal deaths. 15.29% of the babies were Preterm, 8.14% were IUGR babies and 2.35% had congenital anomalies. It was noted NYHA grade III/IV cases had more preterm babies compared to NYHA grade I/II. NICU admissions were also more with NYHA grade III/IV.Conclusions: The results suggest the need for pre-pregnancy counselling, early diagnosis, correction of cardiac lesions where indicated, close surveillance during pregnancy and a team approach comprising of obstetricians, cardiologists, neonatologists and nursing personnel for a successful pregnancy outcome.

scholarly journals Maternal outcomes of rheumatic heart disease in pregnancy

2017 ◽  
Vol 6 (3) ◽  
pp. 802
Author(s):  
Hema Priya L. ◽  
Ambarish Bhandiwad ◽  
Nagaraj Desai ◽  
Triveni Kondareddy
Keyword(s):  
Heart Disease ◽  
Birth Weight ◽  
Functional Status ◽  
Rheumatic Heart Disease ◽  
Cardiac Disease ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Heart Disease In Pregnancy ◽  
Rheumatic Heart ◽  
In Pregnancy

Background: Preexisting cardiac disease is seen in 1-3% of pregnancies. In developing countries, sequelae of rheumatic fever often constitute the majority of women with heart disease; whereas in developed countries, it is the congenital heart diseases. The aim of this study was to examine the changing trends and mode of care of women with Rheumatic heart disease in pregnancy over a period of five years in a tertiary care centre.Methods: Patient records over five years were retrieved and maternal and perinatal outcomes were documented. The present study reports the outcomes of 72 women with rheumatic heart disease.Results: The prevalence of heart disease in pregnancy in our study was 1.72%. The prevalence was higher among the rural population, and in lower socio economic strata. 30% of patients were diagnosed during pregnancy. The risk of complications co - related with their functional status at the onset of pregnancy. The mode of termination of pregnancy and indications for LSCS did not vary. However, the risk of complications was greatest during labour and post-partum period. The mean birth weight was 2.7 kg, however, 30% of term neonates were of low birth weight (<2.5 kg).Conclusions: Rheumatic heart disease continues to be a major cause of cardiac disease complicating pregnancy. However, early diagnosis, appropriate management prior to pregnancy, and good functional status at the time of entering pregnancy allowed for a good maternal and neonatal outcome.

scholarly journals Maternal and perinatal outcomes of pregnancies complicated by cardiac disease at tertiary level hospital of Uttarakhand

2017 ◽  
Vol 6 (8) ◽  
pp. 3338
Author(s):  
Priyanka Chaudhari ◽  
Vineeta Gupta ◽  
Nidhi Kumari ◽  
Archna Tandon ◽  
Nimisha Gupta
Keyword(s):  
Heart Disease ◽  
Cardiac Disease ◽  
Heart Diseases ◽  
Nyha Class ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Cardiac Diseases ◽  
Class Iii ◽  
Maternal Deaths ◽  
Common Cause

Background: Cardiac disease is the most common cause of indirect maternal deaths and most common cause of death overall. It complicates 1% of all maternal deaths. The maternal and neonatal risks associated with pregnancy in women with cardiac disease receiving comprehensive prenatal care have not been well defined. Objective of present study was to evaluate the burden of cardiac diseases in pregnancy in our hospital, their clinical presentation, type of cardiac lesion, associated complications, maternal and fetal outcome.Methods: A retrospective study was conducted in Obstetrics and gynecology department at Shri Guru Ram Rai Institute of medical and health sciences, Dehradun from January- 2013 to December-2015. All patients with cardiac diseases during pregnancy or developed during postpartum period were included in the study. Detailed Demographic profile of patients, mode of delivery, perinatal outcome, associated antenatal, intranatal and postnatal complications were analyzed in detail.Results: There were 37 patients with cardiac disease during pregnancy in our study period. Out of these 32.4% were diagnosed during current pregnancy. Rheumatic heart diseases were seen in 54.05% patients and congenital heart disease seen in 35.1%. out of these 81.1% patients belonged to NYHA class I and II and 18.9% patients in class III & IV. Majority of patients (78.3%) had vaginal delivery. We observed 5.4% maternal mortality and 2.7% of neonatal mortality rate.Conclusions: Pregnancy in women with heart disease is associated with significant cardiac and neonatal complications. Multidisciplinary approach involving cardiologist, obstetrician and neonatologist improves fetomaternal outcome.

scholarly journals Executive function and brain development in adolescents with severe congenital heart disease (Teen Heart Study): protocol of a prospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e032363
Author(s):  
Melanie Ehrler ◽  
Nadja Naef ◽  
Ruth O'Gorman Tuura ◽  
Beatrice Latal
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Executive Function ◽  
Brain Development ◽  
Children And Adolescents ◽  
Prospective Cohort ◽  
Congenital Heart ◽  
Healthy Children ◽  
Functional Brain ◽  
Developmental Problems

IntroductionCongenital heart disease (CHD) is the most frequent congenital malformation. With recent advances in medical care, the majority of patients with CHD survive into adulthood. As a result, interest has shifted towards the neurodevelopmental outcome of these patients, and particularly towards the early detection and treatment of developmental problems. A variety of mild to moderate cognitive impairments as well as emotional and behavioural problems has been observed in this population. However, a more detailed assessment of the various domains of executive function and their association with structural and functional brain development is lacking. Therefore, the current study will examine all domains of executive function and brain development in detail in a large sample of children and adolescents with CHD and healthy control children.Methods and analysisA total of 192 children and adolescents with CHD aged 10–15 years, who participated in prospective cohort studies at the University Children’s Hospital Zurich, will be eligible for this study. As a control group, approximately 100 healthy children will be enrolled. Primary outcome measures will include executive function abilities, while secondary outcomes will consist of other neurodevelopmental measures, including intelligence, processing speed, attention, fine motor abilities and brain development. An MRI will be performed to assess structural and functional brain development. Linear regression analyses will be applied to investigate group differences and associations between executive function performance and neurodevelopmental measures.Ethics and disseminationThis study is supported by the Swiss National Science Foundation (SNF 32003B_172914) and approved by the ethical committee of the Canton Zurich (KEK 2019–00035). Written informed consent will be obtained from all the parents and from children aged 14 years or older. Findings from this study will be published in peer-reviewed journals and presented at national and international conferences for widespread dissemination of the results.

Cardiac disease in pregnancy. Part 2: acquired heart disease

2007 ◽  
Vol 9 (2) ◽  
pp. 83-87 ◽  
Author(s):  
Emily Gelson ◽  
Mark Johnson ◽  
Michael Gatzoulis ◽  
Uebing Abselm
Keyword(s):  
Heart Disease ◽  
Cardiac Disease ◽  
Acquired Heart Disease ◽  
In Pregnancy

scholarly journals Maternal and perinatal outcome in heart disease complicating pregnancy

2021 ◽  
Vol 10 (10) ◽  
pp. 3725
Author(s):  
Tanvi Kumar ◽  
Rishman Tandi ◽  
Amritaa Thalla
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Heart Disease ◽  
Cardiac Disease ◽  
Perinatal Outcome ◽  
Heart Diseases ◽  
Nyha Class ◽  
Morbidity And Mortality ◽  
Elective Cesarean Section ◽  
Perinatal Morbidity

Background: Congenital as well as acquired heart diseases remain one of the important factors complicating pregnancy and remains a significant cause of maternal as well as perinatal morbidity and mortality. Pregnant women with cardiac diseases need a comprehensive management strategy to minimize the adverse effect of cardiac conditions on pregnancy and its outcome.Methods: This was an observational study conducted in a tertiary care hospital located in an urban area. Pregnant patients diagnosed to be having congenital or acquired heart diseases and admitted either in ward, labour room or intensive care unit were included in this study on the basis of a predefined inclusion and exclusion criteria. Detailed history was taken and clinical examination was done in all the cases. Patients were classified according to New York Heart Association. Maternal and perinatal Outcome was studied in cases.Results: The incidence of cardiac disease amongst pregnant patients during study period was found to be 0.58%. The mean age of studied cases was found to be 23.16±5.06 years. Most of the patients were primigravida (85.71%) and 6 patients (14.29%) were multigravida. The majority of the patients (76.19%) belonged to NYHA grade I whereas 8 (19.05%) patients belonged to NYHA class II. 1 patient belonged to NYHA Class III and Class IV respectively. Isolated mitral stenosis secondary to rheumatic valvular involvement was the single most common lesion seen in studied cases and was seen in 8 (19.05%) patients. Ventricular septal defect was most common congenital heart disease (14.28%). 26 (61.90 %) delivered by normal vaginal delivery whereas emergency and elective LSCS was done in 9 (21.43%) and 6 (14.29%) patients respectively. nature of cardiac disease was common factor for elective cesarean section which was done in 5 cases (11.90%). Postpartum cardiac failure (14.29%) and postpartum hemorrhage (9.52%) were common maternal complications. 24 (57.14%) neonates required admission in neonatal intensive care unit. The most common indication for NICU admission was found to be low birth weight (23.81%) followed by birth asphyxia (19.05%).Conclusions: Cardiac disease in pregnancy is associated with increased risk of maternal as well as perinatal morbidity and mortality. Early diagnosis and management during pregnancy is essential to reduce maternal as well as perinatal outcome in these cases.

scholarly journals Spectrum of pediatric heart disease in newly established cardiac center in South Punjab.

2020 ◽  
Vol 27 (11) ◽  
Author(s):  
Ahsan Beg ◽  
Nousheen Fatima ◽  
Abdul Razzaq Mughal
Keyword(s):  
Heart Disease ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Diseases ◽  
Heart Defects ◽  
Ductus Arteriosus ◽  
Female Ratio ◽  
Acquired Heart Disease ◽  
Pediatric Heart Disease ◽  
Cardiac Center

Objectives: To determine the spectrum of pediatric heart disease in a newly established cardiac centre in south Punjab. Study Design: Descriptive Observational Case Series. Setting: Department of Pediatric Cardiology of Cardiac Center Bahawal Victoria Hospital (BVH) Bahawalpur. Period: July 2019 to December 2019. Material & Methods: All consecutive patients of any gender, age range from first day of life to18 years, diagnosed as having heart disease (congenital/ acquired) on Echocardiography were enrolled. Patients of isolated bicuspid aortic valve, premature neonates having PDA or those who already had device or surgical intervention done were excluded from the study. The spectrum of the heart diseases in children was assessed by categorizing them as having acquired, acyanotic and acyanotic heart defects. Results: A total of 624 patients were enrolled in the study on the basis of inclusion criteria. There were 56.7 % male (n=354) while 43.3% were female (n=270) with male to female ratio 1.3:1. Majority of the patients were of infant age group (66%, n=412). Congenital heart disease (CHD) was present in 87% of the patients (n=543) while 13% (n=81) had acquired heart disease (AHD). Acyanotic heart lesions were found in 73.1% of patients while cyanotic congenital heart diseases (CCHD) were 26.9 %. Ventricular septal defect (VSD) was the most common CHD (33%), followed by Atrial Septal defect (14.9%) and Patent ductus arteriosus (13.1%). TOF was the most common CCHD (10.1%) followed by TGA (7.4%). Among AHD, 55.6% were of Rheumatic heart disease (RHD) followed by Cardiomyopathy (27.2), pericardial effusion (8.6%) and infective endocarditis (4.9%). Conclusion: The VSD, ASD, PDA, TOF and TGA remain the most common CHD in descending order while RHD is the most common acquired heart disease in children at our centre.

MATERNALAND FETAL OUTCOME IN PREGNANCY WITH HEART DISEASES

2021 ◽  
pp. 46-47
Author(s):  
Sweety Sinha
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Cardiac Disease ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
In Pregnancy

Background: Cardiac disease is an important cause of maternal mortality and morbidity both in antepartum and postpartum period. The overall incidence of heart disease in pregnancy is <1%. Objective of present study was to determine maternal outcome in pregnant women with heart diseases in terms of fetal complication, maternal complication and Mode of delivery. Methods: This study was conducted in the Department of Obstetrics and Gynaecology at PATNA MEDICAL COLLEGE,HOSPITAL,patna. 40 women with heart disease which were previously established or diagnosed during pregnancy were enrolled in the study. Results:In 40 women pregnancies was complicated by heart disease in the study. The prevalence of heart disease amongst all pregnancies found in hospital was 4.3%. The principal cause of cardiac lesion was Rheumatic heart disease (RHD) (62.5%) while congenital heart disease was seen in 12.5%. Among the women who had RHD, mitral stenosis seen in 15 (37.5%) was most common lesion and Multiple cardiac lesions 10 (25%) women. Among the women with congenital cardiac disease, mitral valve prolapse was most common constituting 5 (12.5%) cases. women delivered by caesarean section were14(35%) while 26(65%) had vaginal delivery. with spontaneous onset of labour in 20(50 %)and assisted instrumental vaginal delivered in 6 patients. There was 1 maternal death. No baby had congenital heart disease. 70% babies born weighed more than 2kg. Conclusions:This study concluded that pre- pregnancy diagnosis, counselling, appropriate referral, antenatal supervision and delivery at equipped centre improve the pregnancy with heart disease outcome for both mother and baby

Cardiac disease in pregnancy

2020 ◽  
pp. 151-162
Author(s):  
Philip Steer
Keyword(s):  
Heart Disease ◽  
Cardiac Disease ◽  
Developed Countries ◽  
Care Needs ◽  
The United Kingdom ◽  
Risk Of Mortality ◽  
Acquired Heart Disease ◽  
Causes Of Mortality ◽  
Preconception Counselling ◽  
Impaired Cardiac Function

Cardiac disease has become the single most important cause of maternal death in the United Kingdom and other developed countries over the last 30 years, mostly due to acquired heart disease secondary to women having their pregnancies later in life. The main causes of mortality are myocardial infarction/ischaemic heart disease (one-third) and cardiomyopathy (a further third). The remaining deaths are mostly associated with rheumatic heart disease, congenital heart disease, and pulmonary hypertension (about 5–10% each). Pregnancy represents a challenge to women with impaired cardiac function because of the cardiovascular changes associated with the increase in blood supply to the uterus and placenta. Preconception counselling is vital and should cover the risk of mortality, morbidity, and the increased rate of preterm birth and fetal growth restriction in affected women. Antenatal and intrapartum care needs to be planned by a multidisciplinary team and delivered by staff with appropriate expertise.

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