Cardiac Defects

Author(s):  
Robin D. Clark ◽  
Cynthia J. Curry

This chapter reviews background information about the incidence, risk factors, genetics, family history, recurrence risk, and epidemiology of isolated and syndromic congenital cardiac anomalies, including septal defects, patent ductus, conotruncal defects, left ventricular outflow tracto obstruction, and congenital intracardiac tumors. The discussion on the differential diagnosis of various types of cardiac anomalies summarizes common causes, including teratogenic agents (pregestational diabetes, maternal phenylketonuria), chromosome anomalies (aneuploidy, recurrent microdeletions, and other copy number variants), and Mendelian disorders associated with multiple congenital anomalies. The chapter gives recommendations for evaluation and management. A clinical case presentation features an infant with a rhabdomyoma caused by tuberous sclerosis.

Author(s):  
Robin D. Clark ◽  
Cynthia J. Curry

This chapter reviews background information about the incidence, risk factors, sex ratio, genetics, recurrence risk, and epidemiology of isolated and syndromic hydrocephalus. Extrinsic causes of hydrocephalus are discussed including prematurity, hemorrhage, maternal Vitamin K deficiency. The discussion on the differential diagnosis of hydrocephalus summarizes its common causes, including teratogenic agents (LCMV, TORCH, parvovirus and other viral infections, isotretinoin, misoprostol), chromosome anomalies (trisomy 9, triploidy, copy number variants), and Mendelian disorder in which hydrocephaly occurs with other CNS anomalies or associated with malformations in other organ systems. The chapter offers recommendations for evaluation and management. A clinical case presentation features an infant with hydrocephalus, ectopic calcifications, a rash and consumptive thrombopenia caused by neonatal-onset multisystem inflammatory disorder.


Author(s):  
Robin D. Clark ◽  
Cynthia J. Curry

This chapter reviews background information about the incidence, risk factors, genetics, recurrence risk, and epidemiology of isolated and syndromic holoprosencephaly, including a summary of its subtypes and microforms (solitary median maxillary central incisor, absent midline frenulum, choanal atresia, pyriform aperture stenosis). The discussion on the differential diagnosis of holoprosencephaly summarizes its common causes, including teratogenic agents (maternal diabetes), chromosome anomalies (aneuploidy, recurrent copy number variants), and Mendelian disorders in which holoprosencephaly is isolated or associated with malformations in other organ systems. This chapter offers recommendations for evaluation and management. A clinical case presentation features an infant with transient neonatal hypernatremia, who was later diagnosed with lobar holoprosencephaly after presenting with dehydration due to diabetes insipidus.


Author(s):  
Robin D. Clark ◽  
Cynthia J. Curry

This chapter reviews background information about the incidence, risk factors, genetics, recurrence risk, and epidemiology of various isolated and syndromic congenital eye anomalies that are apparent in the newborn including anophthalmia, microphthalmia, aniridia, coloboma, cataracts, corneal opacities, and ptosis. The discussion on the differential diagnosis of ocular anomalies summarizes its common causes, including teratogenic agents (alcohol, retinoic acid, rubella, Vitamin A deficiency), chromosome anomalies (aneuploidy, copy number variants), and Mendelian disorders that include multiple congenital anomalies in other organ systems. The chapter provides recommendations for evaluation and management. A clinical case presentation features a dysmorphic male infant with bilateral microphthalmia and opaque corneas who has Lenz microphthalmia syndrome.


Author(s):  
Robin D. Clark ◽  
Cynthia J. Curry

This chapter reviews background information about the incidence, risk factors, genetics, recurrence risk, epidemiology, and some subtypes of syndactyly. Various unilateral and bilateral patterns of syndactyly, including common autosomal dominant isolated cutaneous syndactyly and rarer presentations of complex syndactyly with bony fusion, are reviewed. Associated malformations, such as small size, microcephaly, craniosynostois, facial dysmorphism, and other limb anomalies, that are often seen with syndactyly are presented. The discussion on the differential diagnosis of syndactyly summarizes its common causes, including teratogenic agents, chromosome anomalies, and Mendelian multiple congenital anomaly syndromes, and it gives recommendations for evaluation and management. A clinical case presentation features an infant with oculo-dento-digital dysplasia.


Author(s):  
Robin D. Clark ◽  
Cynthia J. Curry

This chapter reviews background information about the incidence, risk factors, genetics, family history, recurrence risk, and epidemiology of isolated and syndromic diaphragmatic hernia. The chapter reviews the typical multifactorial inheritance pattern of isolated sporadic diaphragmatic hernia and its low recurrence risk, which is distinct from more complex single gene disorders. The discussion on the differential diagnosis of diaphragmatic hernia summarizes other intrathoracic disorders that can give a similar radiographic appearance. The common genetic causes of diaphragmatic hernia are discussed including chromosome anomalies (aneuploidy, mosaic tetrasomy 12p, recurrent copy number variants), and Mendelian disorders that include malformations in other organ systems and overgrowth conditions. The chapter gives recommendations for evaluation and management. A clinical case presentation features a large for gestational age infant with diaphragmatic hernia and bitemporal alopecia caused by Pallister–Killian syndrome.


Author(s):  
Robin D. Clark ◽  
Cynthia J. Curry

This chapter reviews background information about the incidence, risk factors, family history, sex ratio, genetics, recurrence risk, and epidemiology of isolated and syndromic cleft palate. Microforms of cleft palate including bifid uvula, submucous cleft palate, and nasal regurgitation are described. The discussion on the differential diagnosis of cleft palate summarizes its common causes, including teratogenic agents (alcohol, maternal diabetes, valproic acid), chromosome anomalies, and Mendelian disorders associated with malformations in other organ systems. The chapter provides recommendations for evaluation and management. A clinical case presentation features an infant with micrognathia, a cleft of the soft palate, and a retropositioned tongue and respiratory distress due to Pierre–Robin sequence.


Author(s):  
Robin D. Clark ◽  
Cynthia J. Curry

This chapter reviews background information about the incidence, risk factors, genetics, recurrence risk, family history and epidemiology of isolated and syndromic ear anomalies. The discussion on the differential diagnosis of ear anomalies summarizes its common causes, including teratogenic agents (isotretinoin, maternal diabetes, mycophenylate), chromosome anomalies (aneuploidy, 22q11 deletion), common sporadic multiple congenital anomaly syndromes (Hemifacial microsomia/Goldenhar), and Mendelian disorders that are primarily craniofacial (Treacher-Collins and other mandibulofacial dysostoses) and others that include malformations in other organ systems (CHARGE). The chapter gives recommendations for evaluation and management. A clinical case presentation features a child with mycophenylate embryopathy, who had been incorrectly diagnosed with Treacher Collins syndrome.


Author(s):  
Robin D. Clark ◽  
Cynthia J. Curry

This chapter reviews background information about the incidence, sex ratio, risk factors, including CVS and early amniocentesis, family history, consanguinity, genetics, recurrence risk, and epidemiology of clubfoot. The distinctive rigidity of clubfoot is compared with the more common position anomalies of the foot (metatarsus adductus) and congenital vertical talus. The discussion on the differential diagnosis of clubfoot summarizes its common causes, including teratogenic agents, chromosome anomalies, including copy number variants, and Mendelian disorders that involve associated malformations in the neuromuscular, skeletal, and connective tissue systems, and it gives recommendations for evaluation and management. A clinical case presentation features an infant with Loeys–Dietz syndrome.


Author(s):  
Robin D. Clark ◽  
Cynthia J. Curry

This chapter reviews background information about the incidence, risk factors, genetics, recurrence risk, and epidemiology of single suture and multiple suture craniosynostosis including isolated and syndromic varieties. The discussion on the differential diagnosis of craniosynostosis summarizes its common causes, including teratogenic agents (fluconazole, maternal thyroid disorders, methotrexate, valproic acid), chromosome anomalies, and Mendelian disorders that involve extracranial malformations. The relationship between premature closure of cranial sutures of postnatal onset and positional plagiocephaly, prematurity, and microcephaly are examined. This chapter provides recommendations for testing, evaluation and management. A clinical case presentation features an infant with Saethre–Chotzen syndrome, whose mildly affected relatives had not been diagnosed.


Author(s):  
Robin D. Clark ◽  
Cynthia J. Curry

This chapter reviews background information about the incidence, risk factors, genetics, family history, recurrence risk, and epidemiology of heterotaxy and disorders of situs, including polysplenia and asplenia. The relationship between heterotaxy and dysfunction of non-motile primary cilia is explained. The discussion on the differential diagnosis of heterotaxy summarizes its common causes, including teratogenic agents, chromosome anomalies (maternal diabetes mellitus), and Mendelian disorders in which heterotaxy occurs with various patterns (TAPVR) and in association with malformations in other organ systems (Agnathia-Otocephaly). The chapter gives recommendations for evaluation and management. A clinical case presentation features an infant with situs ambiguous and asplenia who had unexpected respiratory distress after surgery due to primary ciliary dyskinesia.


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