Endocarditis

2011 ◽  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Dental Hygiene ◽  
Dental Health ◽  
Bacterial Endocarditis ◽  
Valve Surgery ◽  
Expert Advice ◽  
Endocarditis Prophylaxis ◽  
Device Placement

Endocarditis prophylaxis 222Most congenital heart disease patients have a lifelong risk of bacterial endocarditis (Table 18.1) and hence must be educated regarding: • Symptoms that may indicate endocarditis and when to seek expert advice.• Dental health, good oral hygiene, regular brushing, flossing, and need for regular dental check-ups—good dental hygiene and a recent dental check up must be ensured prior to valve surgery or catheter interventions involving device placement....

ACUTE INFECTIOUS SINUSITIS IN CYANOTIC CONGENITAL HEART DISEASE

PEDIATRICS ◽  
1973 ◽  
Vol 52 (5) ◽  
pp. 692-696
Author(s):  
Amnon Rosenthal ◽  
Kenneth E. Fellows
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Brain Abscess ◽  
Paranasal Sinuses ◽  
Congenital Heart ◽  
Bacterial Endocarditis ◽  
Cyanotic Congenital Heart Disease ◽  
Hematogenous Spread ◽  
Subacute Bacterial Endocarditis

The prevalance and sequelae of infectious sinusitis in a hospitalized group of children with and without congenital heart disease (CHD) were studied. Sinusitis was more common (1% versus 0.3%) in the CHD group and occurred predominantly (90%) in the cyanotic patients. It was associated with subacute bacterial endocarditis in 20% (5 of 20) and brain abscess in 15% (3 of 20) of the CHD cases. It is postulated that proliferation and distension of the venous channels and marrow spaces in patients with cyanotic CHD enhances the hematogenous spread of bacteria from the paranasal sinuses.

THERAPEUTIC PRINCIPLES FOR STREPTOCOCCUS VIRIDANS INFECTIONS: RECURRENT BACTERIAL ENDOCARDITIS IN A CHILD WITH CONGENITAL HEART DISEASE

PEDIATRICS ◽  
1965 ◽  
Vol 35 (4) ◽  
pp. 704-708
Author(s):  
Welton M. Gersony ◽  
Alexander S. Nadas
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Bacterial Endocarditis ◽  
Intravenous Therapy ◽  
Phenoxymethyl Penicillin ◽  
Serum Bactericidal Activity ◽  
Therapeutic Principles ◽  
Penicillin Therapy ◽  
Principles Of Treatment

A case of recurrent bacterial endocarditis due to a relatively resistant alpha streptococcus is reviewed. The following general principles of treatment are recommended: 1. Intravenous penicillin therapy should be instituted in all instances. 2. Should serum bactericidal levels indicate the organism to be extremely sensitive (< 0.1 units/ml) oral phenoxymethyl penicillin (Penicillin-V) may be substituted after 3 weeks. 3. In cases infected with organisms sensitive to greater than 0.1 units/ml, intravenous therapy should be continued for 6 weeks and streptomycin added for 2 weeks. 4. When facilities for studying penicillin sensitivity and serum bactericidal activity are not available, the intravenous penicillin-streptomycin regime is recommended.

Management of Children with Congenital Heart Disease for Noncardiac Surgery

2018 ◽  
Author(s):  
Dean B. Andropoulos
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Systematic Approach ◽  
Preoperative Evaluation ◽  
Noncardiac Surgery ◽  
Inotropic Support ◽  
Surgical Approaches ◽  
Endocarditis Prophylaxis ◽  
Anesthetic Complications

Congenital heart disease (CHD) patients are increasingly presenting for noncardiac surgery, and the anesthesiologist must possess an understanding of the major classes of CHD and their pathophysiology, as well as surgical approaches for correction or palliation. A thorough preoperative evaluation and anesthetic plan, including invasive monitoring, inotropic support, blood transfusion, endocarditis prophylaxis, pacemaker/defibrillator functioning, and intensive care unit admission must be developed, and include a multidisciplinary team. Each patient has a unique pathophysiology and a systematic approach to understanding hemodynamic consequences, and developing hemodynamic goals for the anesthetic will improve the potential to minimize anesthetic complications and ensure the best possible outcomes.

Congenital heart disease in adults

2015 ◽  
Author(s):  
Susanna Price ◽  
Brian F Keogh ◽  
Lorna Swan
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
Disease Patient ◽  
Expert Advice ◽  
Clinical State ◽  
Medical Attention ◽  
Physiological Status ◽  
Number Of Patients

The number of patients with congenital heart disease surviving to adulthood is increasing, with many requiring ongoing medical attention. Although recommendations are that these patients should be cared for in specialist centres, the clinical state of the acutely unwell patient may preclude transfer prior to the instigation of lifesaving treatment. Although the principles of resuscitation in this patient population differ little from those with acquired heart disease, the acutely unwell adult congenital heart disease patient presents a challenge, with potential pitfalls in examination, assessment/monitoring, and intervention. Keys to avoiding errors include: knowledge of the primary pathophysiology, any interventions that have been undertaken, residual lesions present (static or dynamic), and the normal physiological status for that patient-to determine the precise cause for the acute deterioration and to appreciate the effects (detrimental or otherwise) that any supportive and/or therapeutic interventions might have. Expert advice should be sought at the earliest opportunity.

scholarly journals Pulmonary arterial hypertension populations of special interest: portopulmonary hypertension and pulmonary arterial hypertension associated with congenital heart disease

2019 ◽  
Vol 21 (Supplement_K) ◽  
pp. K37-K45 ◽  
Author(s):  
Laurent Savale ◽  
Alessandra Manes
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Congenital Heart ◽  
Expert Advice ◽  
Portopulmonary Hypertension ◽  
Early Screening ◽  
Pulmonary Arterial

Abstract Guidelines exist for management of pulmonary arterial hypertension (PAH), but information is limited for certain patient subgroups, including adults with portopulmonary hypertension (PoPH) or with PAH associated with congenital heart disease (PAH-CHD). This article discusses screening, clinical management, and prognosis in PoPH and PAH-CHD and, as such, considers the most recent clinical data and expert advice. A multidisciplinary consultation and follow-up by specialists are crucial for management of both PoPH and PAH-CHD, but each condition presents with unique challenges. Development of PoPH most commonly occurs among patients with liver cirrhosis. Initially, patients may be asymptomatic for PoPH and, if untreated, survival with PoPH is generally worse than with idiopathic PAH (IPAH), so early identification with screening is crucial. PoPH can be managed with PAH-specific pharmacological therapy, and resolution is possible in some patients with liver transplantation. With PAH-CHD, survival rates are typically higher than with IPAH but vary across the four subtypes: Eisenmenger syndrome, systemic-to-pulmonary shunts, small cardiac defects, and corrected defects. Screening is also crucial and, in patients who undergo correction of CHD, the presence of PAH should be assessed immediately after repair and throughout their long-term follow-up, with frequency of assessments determined by the patient’s characteristics at the time of correction. Early screening for PAH in patients with portal hypertension or CHD, and multidisciplinary management of PoPH or PAH-CHD are important for the best patient outcomes.

The experiences with oral health and dental prevention of children with congenital heart disease

2003 ◽  
Vol 13 (5) ◽  
pp. 439-443 ◽  
Author(s):  
Richard Balmer ◽  
Frances A. Bu'Lock
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Oral Health ◽  
Infective Endocarditis ◽  
Professional Education ◽  
Congenital Heart ◽  
Dental Health ◽  
Dietary Advice ◽  
Dental Disease ◽  
Dental Practitioners

Objective: To examine the degree to which children, considered to be at risk from infective endocarditis, had received professional education and preventive procedures in regard to dental health, and to evaluate the knowledge of their parents of the link between oral health and infective endocarditis. Materials and methods: Questionnaires were distributed to the families of 38 children under the care of paediatric cardiology. A short dental examination was carried out. Parents were asked if they knew why oral health was of particular importance in their child. Results: Of the children, 58% demonstrated evidence of previous or current dental disease, with 24% having had at least one filling, 13% with one or more teeth showing deficiency of enamel, and 39% with untreated dental caries. Only 79% of the children were registered with a dentist. According to Chi squared test, there was no difference in the dental health of registered and non registered children. Of the study group, 29% had received instruction in oral hygiene, 42% had received dietary advice, 13% had received advice regarding fluoride supplementation or had had fluoride professionally applied, and 8% had had fissure sealants. These percentages remained relatively low even if only registered children, or only registered children with previous or current dental disease, were considered. Only 64% of parents were aware of the link between the oral health of their children and infective endocarditis. Parents of children who were registered were more likely to be aware of this link than parents of children who were not registered. Conclusions: In spite of being registered with general dental practitioners, few children with congenital heart disease had received basic education in dental hygiene. Even children known to have had dental disease and, therefore, considered to be more vulnerable, were overlooked.

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