SWEATING IN CONGENITAL HEART DISEASE

PEDIATRICS ◽  
1968 ◽  
Vol 41 (1) ◽  
pp. 123-129
Author(s):  
Blanche P. Alter ◽  
Emily E. Czapek ◽  
Richard D. Rowe
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Sweat Test ◽  
Endocardial Fibroelastosis ◽  
History Of Or ◽  
History Of ◽  
Sweat Tests

Sweating was found to be increased in children with congenital heart disease who had a propensity to congestive heart failure, e.g., children with endocardial fibroelastosis or large or moderate sized left-to-right shunts. This was suggested in a review of cardiac clinic records of 220 patients and was supported by the results of pilocarpine sweat tests which were performed on 34 cardiac patients. By history and by measurement of the amount of sweat produced, children with a history of or tendency toward heart failure could be predicted though patients did not need to be in failure when tested. Contrary to previous opinion, the left-to-right shunt was not in itself sufficient to cause the child to sweat. The shunt had to be large enough to be associated with failure at some time. It is suggested that the pilocarpine sweat test might actually be useful as an aid in predicting a child's potential for heart failure. Several theories regarding the mechanism of sweating in these situations are discussed.

RELATIVE HYPERMETABOLISM IN INFANTS WITH CONGENITAL HEART DISEASE AND UNDERNUTRITION

PEDIATRICS ◽  
1965 ◽  
Vol 36 (2) ◽  
pp. 183-191
Author(s):  
Martin H. Lees ◽  
J. David Bristow ◽  
Herbert E. Griswold ◽  
Richard W. Olmsted
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Congenital Heart Disease ◽  
Oxygen Consumption ◽  
Heart Disease ◽  
Clinical Finding ◽  
Congenital Heart ◽  
Normal Growth ◽  
Respiratory Systems ◽  
Weight For Age

1. Twenty-one infants with various forms of congenital heart disease leading to congestive heart failure, arterial unsaturation, or a combination of both events were studied with respect to resting oxygen consumption. Comparison was made with 21 control infants considered to be of normal growth and to have normal cardiac and respiratory systems. 2. Mean oxygen consumption for infants with heart disease was 9.3±2.4 ml/min/ kg compared to 7.3±0.8 ml/mm/kg for controls. Markedly undergrown infants with heart disease (60% or less of the 50th percentile weight for age) had a mean oxygen consumption of 10.9±1.4 ml/mm/kg compared to a mean of 7.5±2.0 ml/min/kg for infants with heart disease who were greater than 60% of the 50th percentile weight for age. Relative hypermetabolism seemed to relate to the degree of undernutrition rather than to any specific clinical finding. 3. Possible mechanisms of undernutrition and of relative hypermetabolism in the infant with heart disease are discussed.

Abstract 19082: Cardiac Events and Mortality During Admissions for Delivery in Women with Congenital Heart Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Robert M Hayward ◽  
Elyse Foster ◽  
Zian H Tseng
Keyword(s):  
Heart Failure ◽  
Congenital Heart Disease ◽  
Cardiac Arrest ◽  
Heart Disease ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Congenital Heart ◽  
Cardiac Events ◽  
Live Births ◽  
History Of

Background: Labor, delivery, and the postpartum period are a time of increased arrhythmia and congestive heart failure (CHF) incidence. With improvements in the treatment of congenital heart disease (CHD), more women are reaching childbearing age and may be at increased risk for cardiac events and mortality during pregnancy and delivery. Methods: The Healthcare Cost and Utilization Project was used to identify admissions for vaginal and cesarean delivery in California hospitals between 1/1/2005 and 12/31/2011. We compared length of stay, in-hospital mortality, incident CHF, cardiac arrest, and incident arrhythmias for women without CHD to women with non-complex CHD (NC-CHD) and complex CHD (C-CHD). Results: We identified 2,720,980 deliveries resulting in 2,770,382 live births (74% of live births in the state over this period), which included 3,218 women with NC-CHD and 248 women with C-CHD. History of CHF was more common in women with CHD (8.1% for C-CHD, 2.6% for NC-CHD, and 0.08% for women without CHD, p<0.00005 for NC-CHD compared to no CHD and for C-CHD compared to no CHD). Those with CHD were more likely to undergo cesarean section (Table 1). Length of stay was significantly longer in women with CHD (2.6 ± 2.3 days for women without CHD, 3.4 ± 10.2 days for women with NC-CHD and 5.0 ± 13.3 days for women with C-CHD). In-hospital mortality was not significantly higher in women with CHD (Table 1). Incident heart failure, arrhythmias, and cardiac arrest were uncommon in all groups (Table 1). Conclusions: In this study of 2.7 million women admitted to California hospitals for delivery, women with CHD were more likely to undergo cesarean section and had longer length of stay. Despite more frequent history of CHF in women with CHD, incident CHF and arrhythmias were rare during hospitalization. In-hospital mortality and cardiac arrest were not higher in CHD patients. These results suggest that in pregnant women with CHD, cardiac events and mortality at the time delivery are uncommon.

CONGESTIVE HEART FAILURE

PEDIATRICS ◽  
1956 ◽  
Vol 18 (3) ◽  
pp. 491-500 ◽  
Author(s):  
John D. Keith
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Heart Muscle ◽  
Congenital Heart ◽  
Heart Defects ◽  
Age At Onset ◽  
Pericardial Disease ◽  
Great Vessels

HEART failure is associated with an inability of the heart to empty itself adequately, with the result that there is a high venous filling pressure and a decrease in the effective work done by the heart muscle. There are several factors that, if sufficiently severe, will produce congestive heart failure in either infancy or childhood. These include valvular obstruction or insufficiency; mechanical obstruction of the heart as a whole, as in pericardial disease; the physical effects of large intracardiac shunts which increase the load on one or both ventricles; the presence of raised pressure in the pulmonary or systemic circulation; inflammatory reactions in the heart muscle or oxygen lack; and, finally, certain metabolic disturbances, such as hyperthyroidism or hypothyroidism. One or more of these factors may be operating in the same child, as in rheumatic fever where myocarditis is associated with valvular insufficiency, or in congenital heart disease with pulmonary stenosis and patent foramen ovale, where the right ventricle has a high pressure to maintain and is at the same time being offered cyanotic blood from the coronaries. PATIENT MATERIAL In analyzing 1,580 cases of congenital heart disease at the Hospital for Sick Children, Toronto, 20 per cent were found to have had failure at some time. In 90 per cent of these failure occurred in the first year of life. A list of the various causes of heart failure in the pediatric age group in order of frequency follows. [see table in source pdf] In certain types of heart defects failure develops in characteristic age groups. For example, during the first week of life the most common cause of heart failure is aortic atresia. From 1 week to 1 month, coarctation of the aorta leads. From 1 to 2 months, transposition of the great vessels predominates. From 2 to 3 months, endocardial fibroelastosis is the chief cause of heart failure, with transportation of the great vessels second to it. The actual incidence of type of heart defect in relation to age at onset of heart failure is as follows.

scholarly journals Prognostic factor of heart failure in children with left-to-right shunt acyanotic congenital heart disease

2019 ◽  
Vol 59 (2) ◽  
pp. 63-6
Author(s):  
Weny Inrianto ◽  
Indah K. Murni ◽  
Sri Mulatsih ◽  
Sasmito Nugroho
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Congenital Heart Disease ◽  
Logistic Regression ◽  
Heart Disease ◽  
Prognostic Factor ◽  
Congenital Heart ◽  
Defect Size ◽  
And Gender ◽  
Acyanotic Congenital Heart Disease

Background Anemia is highly prevalent and affects morbidity and mortality in adults with acquired heart disease. However, its role in children with acyanotic congenital heart disease (CHD) is unclear. Objective To assess anemia and other potential prognostic factors of congestive failure in children with left-to-right shunt acyanotic CHD. Methods We conducted a case-control study in the Pediatric Cardiology Clinic, Dr. Sardjito Hospital from January to December 2017 in children with left-to-right shunt acyanotic CHD. The case and control groups consisted of subjects with and without heart failure, respectively. Anemia was defined as hemoglobin concentration <11 g/dL. Measured outcome was the prevalence of congestive heart failure, as determined by the Ross criteria. Anemia, defect type, defect size, age at diagnosis, and gender were analyzed by logistic regression analysis as potential predictive factors of heart failure. Results Of 100 children with left-to-right shunt acyanotic CHD, 50 had heart failure (the case group) and 50 did not (the control group). The prevalence of anemia was 45%. Multivariable logistic regression revealed that defect size was the most significant factor for predicting heart failure, with adjusted OR 7.6 (95%CI 2.5 to 22.8) for moderate shunts and 21.1 (95%CI 6.8 to 65.4) for large shunts. Anemia, type of defect, age of diagnosis, and gender were not statistically significant factors for predicting outcomes. Conclusion Anemia is not a significant, prognostic factor for heart failure in children with left-to-right shunt acyanotic CHD. However, moderate and large shunts in children with left-to-right shunt acyanotic CHD are predictive of the occurrence of congestive heart failure.

RHEUMATIC FEVER UNDER 3 YEARS OF AGE

PEDIATRICS ◽  
1968 ◽  
Vol 41 (3) ◽  
pp. 612-619
Author(s):  
Amnon Rosenthal ◽  
Gabor Czoniczer ◽  
Benedict F. Massell
Keyword(s):  
Rheumatoid Arthritis ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Rheumatic Fever ◽  
Congenital Heart ◽  
Streptococcal Infection ◽  
Viral Myocarditis ◽  
Rheumatic Carditis

Ten definite cases of rheumatic fever occurring under 3 years of age are reported. These represent 0.5% of all initial attacks of rheumatic fever in children 16 years old or less admitted to our hospital between 1939 and 1966. Thus, rheumatic fever in the first few years of life is rare but not nonexistent. Our youngest patient was 19 months old. The predominant manifestations of the disease in the first few years of life were carditis and congestive heart failure, and all but one of the patients had significant mitral regurgitation. Polyarthritis was also a common feature. Elevated antistreptolysin-O titers were demonstrated in all cases in which the test was performed. Therefore, evidence of a preceding streptococcal infection is important in considering this diagnosis, even in children under 3 years of age. The differentiation of rheumatic fever from congenital heart disease, viral myocarditis, and rheumatoid arthritis is dicussed. In our experience, the prognosis for the infant with rheumatic carditis has improved since the introduction of penicillin and corticosteroids.

In Reply: Common Clinical Cardiological Problems: The Absence of Arbitrary Answers

PEDIATRICS ◽  
1973 ◽  
Vol 52 (4) ◽  
pp. 620-621
Author(s):  
Jacqueline A. Noonan
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Medical Students ◽  
Congenital Heart ◽  
Good Deal ◽  
Clinical Situation ◽  
Pediatric Cardiologist ◽  
Basic Understanding

The comments above by Drs. Silver and Joos pertain to some important and quite complicated clinical situations. They pose questions which do not lend themselves to simple arbitrary recommendations by the Academy. All involve a good deal of basic understanding of the pathophysiology of congestive heart failure and congenital heart disease in general. I doubt a simple arbitrary recommendation of any of the listed problems could be given which would cover every clinical situation. Active participation by trained pediatric cardiologist in both the training of medical students and house staff is, of course, a good and usual way for "future" pediatricians to learn how to manage "common pediatric cardiologic problems."

Sign in / Sign up

Export Citation Format

Share Document