scholarly journals Diagnostic value of electrocardiography for ventricular septal defect

2019 ◽  
Vol 59 (2) ◽  
pp. 87-91
Author(s):  
Besse Sarmila ◽  
Burhanuddin Iskandar ◽  
Dasril Daud
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Ventricular Septal Defect ◽  
Predictive Value ◽  
Congenital Heart ◽  
Septal Defect ◽  
Diagnostic Value ◽  
Diagnostic Tools ◽  
Diagnostic Study ◽  
Significant Difference

Background Congenital heart disease (CHD) in children requires attention from medical practitioners, because CHDs that are diagnosed early and treated promptly have good prognoses. Ventricular septal defect (VSD) is the most common type of congenital heart disease. Objective To compare the accuracy of electrocardiography (ECG) to echocardiography in diagnosing VSD. Methods This diagnostic study was conducted from November 2013 until July 2015. It involved patients with acyanotic CHDs who were suspected to have VSD at Dr. Wahidin Sudirohusodo Hospital, Makassar, South Sulawesi. Results Of 114 children screened, 97 were included and analyzed. The frequency of positive VSD was 69.1% based on ECG, and 99% based on echocardiography. There was a significant difference between ECG and echocardiography (P=0.000). However, when small VSDs were excluded, there was no significant difference between the two diagnostic tools [(P=1.000), Kappa value was 0.66, sensitivity was 98.5%, specificity was 100%, positive predictive value (PPV) was 100%, and negative predictive value (NPV) was 50%]. Conclusion There were significant differences between the ECG and echocardiography, for diagnosing VSD. However, if small VSDs were not included in the analysis, there was no difference between the two examinations, suggesting that ECG might be useful for diagnosing VSD in limited facilities hospitals.

Abstract 17187: Misinterpretation of Q-waves in Ventricular Septal Defect and Tetralogy of Fallot Patients by Non-Adult Congenital Heart Disease Specialists

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Audrey Thorp ◽  
Alexander Hajduczok ◽  
Sudhanshu Bhatnagar ◽  
Ravi Shah ◽  
William R Davidson
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Ventricular Septal Defect ◽  
Tetralogy Of Fallot ◽  
Predictive Value ◽  
Congenital Heart ◽  
Septal Defect ◽  
Adult Congenital Heart Disease ◽  
Adult Congenital ◽  
Q Wave

Introduction: Tetralogy of Fallot (TOF) and Ventricular Septal Defect (VSD) patients have non-diagnostic Q-waves within inferior (II, III, aVF) or septal (V1-V2) leads on ECG, perhaps due to incomplete conduction through septal defects. Non-diagnostic Q-waves tend to either be wide within a single lead, or deep (3-4mm) in contiguous leads, but do not meet diagnostic criteria for infarct. Hypothesis: Non-Adult Congenital Heart Disease (ACHD) physicians may inaccurately characterize non-diagnostic Q-waves as pathologic opposed to expert interpretation by ACHD-trained physicians in VSD and TOF patients. Thus, misinterpreting ECGs to suggest prior infarct and decreasing their positive predictive value (PPV). Methods: With application of pre-specified inclusion and exclusion criteria, we retrospectively reviewed 72 ECGs from TOF or VSD patients at Penn State Hershey Medical Center from 2002-2020 that were separately read by ACHD and non-ACHD specialists. Primary outcomes were ECGs with diagnosed Q-waves in two separate distributions, inferior or septal leads, by both groups using standard criteria for Q-wave infarct. Reported measures were sensitivity, specificity, PPV, and negative predictive value (NPV). Results: The 72 subjects with isolated TOF or VSD had a mean age of 39 years and 63% were male. Total disease prevalence (presence of Q-waves) was 4.6%. Q-wave infarct diagnosed by non-ACHD physicians had a sensitivity and specificity of 33% and 74% respectively. Their PPV was 5.87% and NPV was 95.85%. Conclusions: This retrospective cohort analysis of TOF and VSD patient ECGs showed the low PPV of non-ACHD physician diagnosis of Q-waves in this respective population. Misinterpretation and misdiagnosis of infarct based off ECG, has ramifications for both the patient and medical system as a whole. Sequelae include, but are not limited to, increasing patient risk for unwarranted medical treatment and affecting hospital billing and insurance coverage.

scholarly journals Stenting of modified Blalock–Taussig shunt in adult with palliated pulmonary atresia and ventricular septal defect: a case report

2019 ◽  
Vol 3 (4) ◽  
pp. 1-4
Author(s):  
Julia Illner ◽  
Holger Reinecke ◽  
Helmut Baumgartner ◽  
Gerrit Kaleschke
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Ventricular Septal Defect ◽  
Pulmonary Artery ◽  
Congenital Heart ◽  
Septal Defect ◽  
Pulmonary Atresia ◽  
Complex Congenital Heart Disease ◽  
Bare Metal

Abstract Background Adults with complex congenital heart disease palliated with systemic-to-pulmonary artery shunts have become rare and represent a particularly challenging patient group for the cardiologist. One of the complications and causes of severe clinical deterioration during long-term follow-up are progressive obstruction or total occlusion of the shunt. The risk for surgical intervention is frequently high and catheter intervention may be complicated by complex anatomy and shunt calcification. Case summary We report the case of a 47-year-old man with uncorrected (palliated) pulmonary atresia and ventricular septal defect who presented with progressive cyanosis (oxygen saturation 69%) and decreasing exercise capacity. Computed tomography revealed a totally occluded modified left Blalock–Taussig (BT) shunt and a severely stenosed central shunt (Waterston–Cooley) in a patient with confluent but hypoplastic pulmonary arteries and multiple major aortic pulmonary collaterals. Due to a high operative risk, an interventional, percutaneous approach was preferred to re-do surgery. From a radial access the calcified BT shunt could be crossed with a hydrophilic guidewire. Then, a rotational thrombectomy, balloon dilatation, and bare-metal stenting at the proximal and distal anastomoses were performed. Post-interventionally, peripheral oxygen saturation increased from 69% to 82%. Clopidogrel was administered for 1 month after bare-metal stenting. At 1-year follow-up, the BT shunt was still patent on echocardiography and exercise tolerance markedly improved. Discussion This case highlights the benefit of percutaneous rotational thrombectomy followed by stenting of chronically occluded systemic-to-pulmonary artery shunts for further palliation in adult patients with complex congenital heart disease not suitable for surgical repair.

scholarly journals Lung function test in children with left-to-right shunt congenital heart disease

2018 ◽  
Vol 58 (4) ◽  
pp. 165-9
Author(s):  
Carolina Kurniawan ◽  
Indah Kartika Murni ◽  
Sasmito Nugroho ◽  
Noormanto Noormanto ◽  
Roni Naning
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Lung Function ◽  
Congenital Heart ◽  
Vital Capacity ◽  
Septal Defect ◽  
Forced Expiratory Volume ◽  
Significant Difference ◽  
Restrictive Lung Function

Background Increased pulmonary blood flow may lead to abnormal lung function in children with left-to-right (L to R) shunt congenital heart disease. This condition has been linked to considerable mortality and morbidity, including reduced lung function. Objective To assess for lung function abnormality in children with L to R shunt congenital heart disease. Methods We conducted a cross-sectional study involving children aged 5-18 years and diagnosed with L to R shunt congenital heart disease at Dr. Sardjito Hospital from March to May 2017. Subjects underwent spirometry tests to measure forced expiratory volume-1 (FEV-1), forced vital capacity (FVC), and forced expiratory volume-1 (FEV-1)/forced vital capacity (FVC). Results Of 61 eligible subjects, 30 (49.2%) children had atrial septal defect (ASD), 25 (41%) children had ventricular septal defect (VSD), and 6 (9.8%) children had patent ductus arteriosus (PDA). Spirometry revealed lung function abnormalities in 37 (60.7%) children. Restrictive lung function was documented in 21/37 children, obstructive lung function in 11/37 children, and mixed pattern of lung function abnormality in 5/37 children. Pulmonary hypertension was found in 21 children. There was no significant difference in lung function among children with and without pulmonary hypertension (P=0.072). Conclusion Abnormal lung function is prevalent in 60.7% of children with L to R shunt congenital heart disease, of which restrictive lung function is the most common. There was no significant difference in lung function among children with and without pulmonary hypertension.

scholarly journals On non-healing of the interventricular septum of the heart (Roger's disease)

1935 ◽  
Vol 31 (1) ◽  
pp. 27-35
Author(s):  
F. F. Piaid
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Ventricular Septal Defect ◽  
Pulmonary Artery ◽  
Congenital Heart ◽  
Septal Defect ◽  
Interventricular Septum ◽  
Artery Stenosis ◽  
Pulmonary Artery Stenosis

Simple uncomplicated forms of congenital heart disease in adults - pulmonary artery stenosis, non-healing of the Botall's duct - although they are a rarity, still studied more or less enough, and their lifelong recognition is not particularly difficult. Unfortunately, this cannot be said of another heart anomaly, a ventricular septal defect.

scholarly journals Recurrent cerebral abscess in tetralogy of Fallot

2016 ◽  
Vol 44 (5) ◽  
pp. 206
Author(s):  
Wanty Sahli ◽  
J M Ch Pelupessy
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Ventricular Septal Defect ◽  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Congenital Heart ◽  
Ventricular Hypertrophy ◽  
Septal Defect ◽  
Pulmonary Stenosis ◽  
Cerebral Abscess

Tetralogy of Fallot (TF) classically consistsof the combination of right ventricularoutflow obstruction (pulmonary stenosis),ventricular septal defect (VSD), overridingaorta, and right ventricular hypertrophy. Thedegree of pulmonary stenosis and VSD determine thevariety of clinical manifestations.This type of congenital heart disease accountsfor about 10% of all congenital cardiac deformitiesand is the most common cyanotic lesion after thefirst year of life. Cerebral abscess is a serious com-plication in TF and is usually seen after the age of 2years.

Ventricular septal defect with anomalous origin of the left descending coronary artery from the right sinus of Valsava and an intraseptal course

2021 ◽  
pp. 021849232110470
Author(s):  
Guillaume Carles ◽  
Marianne Peyre ◽  
Alexia Dabadie ◽  
Loïc Macé ◽  
Marien Lenoir
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Coronary Artery ◽  
Ventricular Septal Defect ◽  
Congenital Heart ◽  
Septal Defect ◽  
The Right ◽  
Coronary Compression ◽  
Anatomic Result

Patients with anomalous aortic origin of the left anterior descending coronary artery (AAOCA) from the right sinus of Valsava, and associated with a trans-septal course, are recommended for surgery only when symptoms of ischemia are present. The transconal unroofing method is straightforward and provides good anatomic result. In absence of significant coronary compression, surgical management of the trans-septal coronary course is proposed if the patient is a candidate to cardiac surgery for another reason, such as congenital heart disease. We describe a transconal approach in a patient with a trans-septal coronary artery and a ventricular septal defect.

scholarly journals Inferring novel lncRNA associated with Ventricular septal defect by DNA methylation interaction network

2018 ◽  
Author(s):  
Min Zhang ◽  
Yue Gu ◽  
Mu Su ◽  
Shumei Zhang ◽  
Chuangeng Chen ◽  
...  
Keyword(s):  
Gene Expression ◽  
Dna Methylation ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Ventricular Septal Defect ◽  
Embryonic Development ◽  
Congenital Heart ◽  
Septal Defect ◽  
Interaction Network ◽  
Rank Test

AbstractVentricular septal defect (VSD) is one of the most common types of congenital heart disease. To find more and more molecular alteration is conducive to explore the mechanism and biomarker in VSD. Herein we devised a predictive strategy to uncover novel lncRNA of VSD integrating DNA methylation, gene expression and lncRNA expression of early embryo and VSD by profiles from GEO database. In totally, 175 lncRNAs, 7290 genes and 3002 DNA methylation genes were obtained by logistic regression analysis associated with embryonic development. Moreover, 7304 DMGs were significant differential methylated by Wilcoxon rank test and Student’s test in VSD. We constructed the lncRNA-mRNA co-expression network in embryo (LMCNe). Then, a reconstructed co-expression weighted network (RCWN) was built integrated LMCNe and the DNA methylation associated network (DMAN) based on the correlation of the DNA methylation level and protein interaction network between embryonic development and VSD. We extracted top 10 lncRNAs with higher score performing DRaWR from the weight network, which as potential VSD related lncRNAs. Six lncRNAs showed a high level of expression in the heart tissue recorded in the NONOCOND database. Furthermore, associated lncRNA genes DCAF8L1, NIT1, SH2D7 and DOCK9-AS2 in validated samples showed a prominently association with VSD. These outcomes provide a reference for lncRNA involved in VSD initialization and a new insight for studies of VSD-associated lncRNAs.Author SummaryVentricular septal defect (VSD) is one of the most common types of congenital heart disease and has a high mortality rate in infants. Many molecular markers have proved effective as biomarker in VSD like DNA methylation and lncRNA. lncRNA is a type of non-coding RNA which has important effect in regulation gene expression and disease occurrence. VSD is an embryonic stage developmental disease. Therefore we hypothesized that lncRNA which was associated with DNA methylation and mRNA in early embryonic development may also affect the occurrence of VSD. So in this work, from the perspective of embryonic development, we devised a predictive strategy to uncovering novel lncRNA of VSD. In our result, four lncRNA associated genes were found differential expressed in VSD and normal samples by qPCR validation. The identification of lncRNA associated with ventricular septal defect is beneficial to further study the mechanism of VSD from the molecular level and also provides a good molecular marker for clinical therapeutic and diagnosis. At the same time, it also provides a new insight for the researches of lncRNA associated with VSD.

scholarly journals Obesity in Patient with Grown Up Congenital Heart Disease (GUCH) Ventricular Septal Defect (VSD) with Pulmonary Hypertension in Sanglah Hospital, Bali

2017 ◽  
Vol 3 (2(S)) ◽  
pp. 16
Author(s):  
Natasya N., et al
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Ventricular Septal Defect ◽  
Congenital Heart ◽  
Septal Defect

Obesity in Patient with Grown Up Congenital Heart Disease (GUCH) Ventricular Septal Defect (VSD) with Pulmonary Hypertension in Sanglah Hospital, Bali

scholarly journals Radiofrequency catheter ablation for ventricular tachycardia using robotic magnetic navigation technology in a teenager after surgery of congenital heart disease and transcatheter closure of ventricular septal defect using an occluder: a case report

2021 ◽  
Vol 26 (8) ◽  
pp. 4229
Author(s):  
A. V. Ponomarenko ◽  
Egor Alexeyevich Morzhanaev ◽  
I. L. Mikheenko ◽  
A. B. Romanov
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Case Report ◽  
Radiofrequency Ablation ◽  
Ventricular Septal Defect ◽  
Congenital Heart ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Magnetic Navigation

Introduction. The case report describes radiofrequency ablation of ventricular tachycardia (VT) using robotic magnetic navigation (RMN) in a teenager after surgery of congenital heart disease (CHD) and transcatheter closure of ventricular septal defect (VSD) using an occluder.Short description. The 16-year-old female patient was operated on in 2005 for CHD. In 2018, the patient underwent resection of ascending aortic sub-valvular membrane, followed by transcatheter closure of VSD with an occluder. After surgery, VT of 294 bpm was documented, which required an emergency hospitalization. Decision was taken to perform a radiofrequency ablation (RFA) using RMN. RFA was performed from the pulmonary artery valve through the scar to upper occluder edge spreading to tricuspid valve. After procedure, VT paroxysms were not induced with all pacing types. According to ECG series and 24-hour Holter monitoring on the 2nd day after surgery, VT episodes were not recorded. During the 6-month follow-up period, VT episodes were not registered without taking antiarrhythmic drugs.Discussion. This case report demonstrates the effectiveness of using RMN system for VT ablation in a teenager with CHD, who underwent open surgical interventions and transcatheter VSD closure using an occluder.

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