Late presentation of the Fontan circulation

2020 ◽  
pp. 29-40
Author(s):  
Hannah Bellsham-Revell ◽  
Aaron Bell ◽  
Catherine Head
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Medical Therapy ◽  
Congenital Heart ◽  
Late Presentation ◽  
Fontan Circulation ◽  
Complex Congenital Heart Disease ◽  
Fontan Patient ◽  
Protein Losing Enteropathy ◽  
Life Threatening

A 16-year-old boy presented to the congenital heart disease department with oedema and chronic cough productive of casts. He had previously undergone Fontan completion for complex congenital heart disease overseas. Examination and basic investigations showed relapsed protein-losing enteropathy and plastic bronchitis, two significant complications of the Fontan circulation. He was extensively investigated, and his medical therapy optimized. Although initially referred for heart transplant assessment, he has been taken off the transplant list after good response to medical therapy alone. This case shows the complex multidisciplinary management of the adolescent Fontan patient with life-threatening complications.

scholarly journals Coxiella Endocarditis as the Cause of Recurrent Fever and Brain Abscess in a Patient with Complex Congenital Heart Disease: A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Ioannis A. Ziogas ◽  
Alexandros P. Evangeliou ◽  
Olga Tsachouridou ◽  
Alexandra Arvanitaki ◽  
Afroditi Tsona ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Case Report ◽  
Congenital Heart ◽  
Diagnostic Delay ◽  
Unknown Origin ◽  
Recurrent Fever ◽  
Complex Congenital Heart Disease ◽  
Empiric Antibiotic ◽  
Life Threatening

Introduction. Blood culture-negative infective endocarditis (BCNIE) can present subtly and is associated with a diagnostic delay leading to increased morbidity and mortality. Case Report. We present the case of an 18-year-old male with a history of complex congenital heart disease and 3-year intermittent episodes of fever of unknown origin, who was referred to our hospital for upper and lower extremity focal seizures. Laboratory blood tests were normal, blood cultures were negative, and brain imaging revealed an abscess. Cardiology consultation was requested, and transthoracic echocardiography revealed an intracardiac vegetation. Empiric antibiotic treatment with sultamicillin, gentamycin, and meropenem was initiated. Serology testing was positive for Coxiella burnetii, and the diagnosis of BCNIE was established. The antibiotic course was changed to oral doxycycline for 36 months and led to resolution of IE, with no vegetation detected on TTE after 15 months. Conclusion. BCNIE is a life-threatening disease entity that can lead to severe complications, such as valve regurgitation, emboli, and death. Patients with congenital heart disease are particularly vulnerable to IE. Timely diagnosis and antibiotic management are of paramount importance in order to avoid the potentially fatal sequelae.

scholarly journals The Appearance of an Underrecognized Congenital Heart Disease in a Patient With COVID-19 Pneumonia

2021 ◽  
Vol 9 ◽  
pp. 232470962110433
Author(s):  
Sofia Lakhdar ◽  
Chandan Buttar ◽  
Sameen Hassan ◽  
Most Sirajum Munira ◽  
Theo Trandafirescu
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Surgical Repair ◽  
Late Presentation ◽  
Complex Congenital Heart Disease ◽  
Productive Cough ◽  
Shortness Of Breath

A 60-year-old woman presented to the emergency department with worsening shortness of breath and non-productive cough for 1 week, which was preceding a recent COVID-19 infection. At the time the patient thought this was part of the constellation of symptoms of COVID-19, so she stayed home until her symptoms worsened to the point of needing hospitalization. The patient was found to have a rare and complex congenital heart disease that led her to develop acute heart failure precipitated by COVID-19 pneumonia. Medical management and surgical repair were essential in this patient given the late presentation.

Should Parents of Children With Congenital Heart Disease and Life-Threatening Dysrhythmias Be Taught Cardiopulmonary Resuscitation?

PEDIATRICS ◽  
1989 ◽  
Vol 84 (6) ◽  
pp. 1102-1104
Author(s):  
SARAH S. HIGGINS ◽  
CHRISTIAN E. HARDY ◽  
STANLEY M. HIGASHINO
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Cardiopulmonary Resuscitation ◽  
Congenital Heart ◽  
Complex Congenital Heart Disease ◽  
Life Threatening ◽  
At Home

In conclusion, CPR at home can be successfully performed by parents who have been given adequate training. As a result of the findings of this study, our recommendation is that training in CPR should be taught to all parents of children with life-threatening dysrhythmias and complex congenital heart disease.

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