scholarly journals What the Pediatrician should know about Congenital Heart Disease

2017 ◽  
Vol 15 (1-2) ◽  
pp. 55
Author(s):  
Dan G. McNamara
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Early Diagnosis ◽  
Clinical Evaluation ◽  
Cardiac Dysfunction ◽  
Congenital Heart ◽  
Traditional Methods ◽  
Cardiac Center

Initial recognition of congenital heart disease in the neonate as well as decisions for referral to a cardiac center for subsequent management are usually the responsibility of the pediatrician. While the malformations of the heart sometimes present obvious mamifestions in the newborn, the early diagnosis is more often elusive and the type and severity of cardiac dysfunction can be obscure, especially when only traditional methods of clinical evaluation are used.

Abstract 14771: Obstructive Sleep Apnea is Associated With Cardiac Dysfunction in Children With Congenital Heart Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Daniel Combs ◽  
Vanessa Fernandez ◽  
brent j barber ◽  
Wayne J Morgan ◽  
Chiu-Hsieh Hsu ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Obstructive Sleep Apnea ◽  
Heart Disease ◽  
Sleep Apnea ◽  
Right Ventricular ◽  
Cardiac Dysfunction ◽  
Congenital Heart ◽  
Left Ventricular ◽  
Sleep Study ◽  
Obstructive Sleep

Introduction: Obstructive sleep apnea (OSA) is associated with cardiac dysfunction in children without congenital heart disease (CHD). Children with CHD are at increased risk for OSA and may be susceptible to further cardiovascular consequences due to OSA but the extent and nature of such cardiovascular effects of OSA are unknown. Methods: Children (6-17 years old) with corrected CHD without current cyanosis or Down syndrome were recruited from pediatric cardiology clinic. Home sleep tests were done to determine the presence and severity of OSA. OSA was defined as an obstructive apnea hypopnea index (oAHI) ≥1. Mild OSA was defined as an oAHI of ≥1 to <5 and moderate OSA was defined as an oAHI of ≥5 to <10. Standard clinically indicated echocardiograms were performed in clinic. Echocardiographic findings were compared between children with CHD with and without comorbid OSA using t-tests, Wilcoxon-sign rank tests as well as linear or logistic regression as appropriate. Results: Thirty-two children had sleep study and echocardiographic data available. OSA was present in 18 children (56%). OSA was mild in 89% and moderate in 11% of cases. There were no significant differences in age, body mass index, CHD severity, gender or ethnicity between children with and without OSA. Children with OSA had larger height-indexed right ventricular end-diastolic diameter (RVDi) compared to those without OSA (median 1.35, 95% CI 1.09, 1.56 vs. 1.21, 95% CI 1.01, 1.57; p=0.04). Children with moderate OSA had a reduced left ventricular shortening fraction compared to both those with mild OSA and no OSA (30.0 ± 6.1% vs. 38.7 ± 4.4%; p=0.009 and 39.2 ± 3.6%; p=0.007, respectively). Children with moderate OSA had increased left ventricular end-systolic diameter compared to those with mild OSA and no OSA (3.4 ± 0.4 cm vs. 2.5 ± 0.4; p=0.007 and 2.4 ± 0.5; p=0.001, respectively). Children with an RVDi above the median were seven times more likely to have OSA than those with an RVDi below the median (odds ratio 6.9.; 95% CI 1.3, 35; p=0.02). Conclusions: OSA is associated with changes in cardiac morphology and reduced contractility in children with CHD. Additionally, the presence of right ventricular dilation may suggest the need for OSA evaluation in children with CHD.

Early Diagnosis of Congenital Heart Disease: When and How to Treat

Neonatology ◽  
2018 ◽  
pp. 1-13
Author(s):  
Francesca R. Pluchinotta ◽  
Luciane Piazza ◽  
Angelo Micheletti ◽  
Javier Fernandez Sarabia ◽  
Diana Negura ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Early Diagnosis ◽  
Congenital Heart

scholarly journals Disparities in Congenital Heart Disease Mortality Based on Proximity to a Specialized Pediatric Cardiac Center

Circulation ◽  
2020 ◽  
Vol 141 (12) ◽  
pp. 1034-1036 ◽  
Author(s):  
Jonathan R. Kaltman ◽  
Kristin M. Burns ◽  
Gail D. Pearson ◽  
David C. Goff ◽  
Frank Evans
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Disease Mortality ◽  
Cardiac Center

scholarly journals Universal Pulse Oximetry Screening for Early Detection of Critical Congenital Heart Disease

2016 ◽  
Vol 10 ◽  
pp. CMPed.S33086 ◽  
Author(s):  
Praveen Kumar
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Early Detection ◽  
Early Diagnosis ◽  
Pulse Oximetry ◽  
Congenital Heart ◽  
Developed Countries ◽  
The United States ◽  
Critical Congenital Heart Disease ◽  
Pulse Oximetry Screening

Critical congenital heart disease (CCHD) is a major cause of infant death and morbidity worldwide. An early diagnosis and timely intervention can significantly reduce the likelihood of an adverse outcome. However, studies from the United States and other developed countries have shown that as many as 30%–50% of infants with CCHD are discharged after birth without being identified. This diagnostic gap is likely to be even higher in low-resource countries. Several large randomized trials have shown that the use of universal pulse-oximetry screening (POS) at the time of discharge from birth hospital can help in early diagnosis of these infants. The objective of this review is to share data to show that the use of POS for early detection of CCHD meets the criteria necessary for inclusion to the universal newborn screening panel and could be adopted worldwide.

Effect of Acculturation and Distance From Cardiac Center on Congenital Heart Disease Mortality

PEDIATRICS ◽  
2012 ◽  
Vol 129 (6) ◽  
pp. 1118-1124 ◽  
Author(s):  
D. E. Fixler ◽  
W. N. Nembhard ◽  
P. Xu ◽  
M. K. Ethen ◽  
M. A. Canfield
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Disease Mortality ◽  
Cardiac Center

Pediatric cardiac surgery in Indonesia

1998 ◽  
Vol 8 (4) ◽  
pp. 437-439 ◽  
Author(s):  
Toshihide Asou ◽  
Jusuf Rachmat
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Surgical Outcome ◽  
Congenital Heart ◽  
Pediatric Cardiac Surgery ◽  
Cardiac Surgeons ◽  
Cardiac Center ◽  
Doctors And Nurses ◽  
At Home

AbstractPediatric cardiac surgery in Indonesia first developed thanks to the cooperation of various cardiac centers abroad. The establishment of the ‘Harapan Kita’ National Cardiac Center in 1985 was one of the most important initial steps. Thereafter, the discipline advanced remarkably in terms of the number of the operations performed and the variety of the diseases treated and, as a result, the surgical outcome also improved. Numerous problems remain to be solved. Only 1% of the children with congenital heart disease are today properly treated in Indonesia. Some of the underlying problems responsible for this situation include a shortage of pediatric cardiac professionals, the lack of the information and education on the part of the patients, and a shortage of funding, both privately and publicly. It would thus be welcome for pediatric cardiac surgeons, cardiologists and nurses in Indonesia to learn about congenital heart disease from doctors and nurses in advanced countries in order to improve the outlook at home.

scholarly journals Nutritional status and associated factors among children with congenital heart disease in selected governmental hospitals and cardiac center,Addis Ababa Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rediet Woldesenbet ◽  
Rajalakshmi Murugan ◽  
Feven Mulugeta ◽  
Tamirat Moges
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Nutritional Status ◽  
Associated Factors ◽  
Congenital Heart ◽  
Addis Ababa ◽  
Reference Ranges ◽  
Healthy Children ◽  
Z Scores ◽  
Cardiac Center

Abstract Background Children with congenital heart disease are at risk for poor growth and under-nutrition compared with healthy children. The aim of this study was to assess the nutritional status of children with congenital heart disease and associated factors in selected governmental hospitals and cardiac center Addis Ababa, Ethiopia. Method Institutional based cross sectional study among 373 children aged under15 years was conducted from February to March; 2021G.c. Data was collected using structured questionnaire and chart review. Z-scores based on WHO reference ranges were used. Anthropometric z-scores based on WHO 2007 reference ranges were generated for each child. Weight-for-age z-scores for children 0–10 years and height-for-age and BMI-for-age z-scores for all children. Binary logistic regression was used for associated factors. Result A total of 373 children were participated in this study. The prevalence of wasting and stunting was 144(38.6%) and 134(35.9%) respectively. The prevalence of underweight and malnutrition in children under 10 years was 143(43.1%). Most of the children were diagnosed with VSD (36.7%). Children age group of 13 months-5 years were associated with wasting and underweight [AOR = 0.434, 95%CI: (0.231, 0.816)] and [AOR = 0.360, 95%CI: (0.183, 0.711)] respectively. Children diagnosed with PAH were 1.885 times more likely to be underweight [AOR = 1.885, 95%CI: (1.094, 3.246)]. When the hemoglobin level increases by every unit per g/dl the chance to be wasting and underweight decreases by 13.1 and 18.6%[AOR = 0.869, 95%CI: (0.792, 0.955)] and [AOR = 0.869, 95%CI: (0.792, 0.955)] respectively. The level of SPO2 is associated with stunting and underweight [AOR = 0.970, 95%CI: (0.943, 0.998)] and [AOR = 0.970, 95%CI: (0.943, 0.998)] respectively. Conclusion The prevalence of malnutrition in children with CHD is pretty high. Decreased level of hemoglobin and SPO2 was found to be associated factors for malnutrition in this case. There need to be a new strategy about including different health professional while care giving.

scholarly journals Long-term survival in patients with isolated pulmonary valve stenosis: a not so benign disease?

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001836
Author(s):  
Kristofer Skoglund ◽  
Annika Rosengren ◽  
Georgios Lappas ◽  
Maria Fedchenko ◽  
Zacharias Mandalenakis
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Early Diagnosis ◽  
Congenital Heart ◽  
Pulmonary Valve ◽  
Survival Rates ◽  
Pulmonary Valve Stenosis ◽  
Term Survival ◽  
Risk Of Mortality

Background and objectivesDuring the last decades, the survival rates in patients with congenital heart disease have increased dramatically, particularly in patients with complex heart malformations. However, the survival in patients with simple defects is still unknown. We aimed to determine the characteristics and the risk of mortality in patients with isolated pulmonary valve stenosis (PS).MethodsSwedish inpatient, outpatient and cause of death registries were used to identify patients born between 1970 and 2017 with a diagnosis of PS, without any other concomitant congenital heart lesion. For each patient with PS, 10 control individuals without congenital heart disease were matched by birth year and sex from the total population registry. We used median-unbiased method and Kaplan-Meier survival analysis to examine the risk of mortality.ResultsWe included 3910 patients with PS and 38 770 matched controls. The median age of diagnosis of PS was 0.7 years (IQR 0.3–7.0). During a median follow-up of 13.5 years (IQR 6.5–23.5), 88 patients with PS and 192 controls died; 500 patients with PS (12%) underwent at least one transcatheter or surgical valve intervention. The overall mortality rate was significantly higher in patients with PS compared with matched controls (HR 4.67, 95% CI 3.61 to 5.99, p=0.001). Patients with an early diagnosis of PS (0–1 year) had the highest risk of mortality (HR 10.99, 95% CI 7.84 to 15.45).ConclusionsIn this nationwide, register-based cohort study, we found that the risk of mortality in patients with PS is almost five times higher compared with matched controls. Patients with an early diagnosis of PS appears to be the most vulnerable group and the regular follow-up in tertiary congenital heart units may be the key to prevention.

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