What's New in Cardiology

1995 ◽  
Vol 16 (12) ◽  
pp. 443-447
Author(s):  
H. Scott Baldwin
Keyword(s):  
Congenital Heart ◽  
Heart Diseases ◽  
Pediatric Population ◽  
Medical Intervention ◽  
First Year ◽  
Recent Developments ◽  
Contemporary Management ◽  
Antiarrhythmic Medications ◽  
And Function ◽  
First Year Of Life

Congenital heart diseases occur with a frequency of 0.5 to 1 case per 1000 live births, accounting for more than 50% of reported birth defects. In addition, they are the leading cause of infant mortality in the first year of life. Significant progress in the diagnosis and treatment of most defects has been made in the past few years. In addition, new experimental evidence suggests that we soon may be able to identify the genes involved in disturbed cardiac anatomy and function. The following is a brief overview of some of the more recent developments that have made an important impact on the contemporary management of the child who has congenital heart disease. Transcatheter Ablation of Pediatric Tachyarrhythmias: A Cure Without Medication The prevalence of tachyarrhythmias within the general pediatric population is such that virtually every practitioner is faced with diagnostic and management considerations that involve patients from birth through adolescence. Fortunately, most tachyarrhythmias can be managed with relatively benign pharmacologic therapies. However, there is a subset of patients who do not respond to "simple" medical intervention, requiring multiple or more potent antiarrhythmic medications that may involve frequent or prolonged hospitalizations for monitoring and optimization of therapeutic regimens. These medications also may cause significant side effects and often result only in a decrease, not elimination, of the arrhythmia.

scholarly journals The Characteristics and Distribution of Congenital Heart Disease in Outpatient Clinic and Inpatient Ward of RSUD Dr. Soedono Madiun East Java in Year 2015

2018 ◽  
Vol 4 (1) ◽  
pp. 9
Author(s):  
Finariawan Finariawan ◽  
Syifa Mahmud S.A.
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Congenital Heart ◽  
Treatment Plan ◽  
Medical Intervention ◽  
First Year ◽  
First Year Of Life

Background: Congenital heart disease is a heart abnormality that presents at birth and fatal in the majority of the case. Congenital heart disease affecting up to 8-10 in every 1,000 newborn. Methods: This study was a descriptive research about the characteristics and distribution of congenital heart disease at ward and clinic of a government hospital in East Java for a year, by investigating medical record from 1 January 2015 – 31 December 2015. We classified and analyzed the patients based on the different groups of age, gender, type of congenital heart disease, the age of first diagnosed, nutritional status, co-morbidities of the disease, medical intervention, and the funding. Result: Total sample from this research was 49 subjects, consist of 53% male and 46% female. CHD was mostly diagnosed in the first year of life (75%), with acyanotic CHD as the most common type. Malnutrition was found in 51% of the subjects. Nonsurgical medical intervention was the most common management performed to treat the condition (97%). The funding with National Health Insurance (PBI or non-PBI) was used in more than half of the subjects (51%). Conclusion: As the conclusion, CHD was commonly found in the first year of life with noncyanotic type dominated the CHD patients. As the highly cost of this disease, it was surprising that only half of the subjects were covered by National Health Insurance. A good funding resource was really needed to make sure the treatment plan of the diseases was well executed.

scholarly journals Influence of congenital heart disease-caused hypoxia on intrathymic development of t-lymphocytes in children of first year of life

2019 ◽  
Vol 36 (4) ◽  
pp. 46-54
Author(s):  
N. P. Loginova ◽  
V. A. Chetvertnykh ◽  
G. A. Khromtsova ◽  
R. M. Shekhmametyev ◽  
L. A. Chetvertnykh
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
T Lymphocytes ◽  
T Lymphocyte ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Immunological Methods ◽  
First Year ◽  
First Year Of Life ◽  
Degree Of Severity

Aim. To study the influence of hypoxia, caused by congenital heart disease, on the intrathymic development of T-lymphocytes and provision of the organism with T-cellular resource in children with cardiac pathology of different degree of severity. Materials and methods. The paper presents the results of complex immunomorphological study of the thymus in children of the first year of life (n = 129) with congenital heart diseases. Hystochemical and immunological methods were used to assess the influence of congenital heart disease-caused hypoxia on the functional status of thymus regarding provision of a child with T-lymphocytes. Results. It was established that the degree of severity of congenital heart disease correlated with the degree of suppression of T-lymphocyte pool formation. During the first year of life, proliferative activity of thymocytes (assessed by Ki-67 expression) in the thymus falls, being the reason of decrease in the number of CD3+ thymocytes. In conditions of marked hypoxia (blue type of defect) the process of T-lymphocyte differentiation is inhibited that causes preservation of less mature forms of thymocytes. As a result, hypoxia is the reason of proliferation suppression and thymocyte differentiation, influencing subpopulation composition of the cells. Thus, insufficient quantity of thymic migrants enters the peripheral blood that confirms low functional activity of thymus regarding provision of the organism with T-cellular resource. Conclusions. No doubt, it can be the cause of immunodeficient state and reduced formation of adaptive immunity in this category of children.

scholarly journals Dynamic electroneurostimulation in the prevention of broncho-pulmonary complications with children of the first year of life suffering from congenital heart diseases in the early post-operating period

2019 ◽  
Vol 18 (1) ◽  
pp. 4-8
Author(s):  
Artavazd A. Pnjoyan ◽  
Yuliya M. Borzunova ◽  
Andrey A. Fedorov ◽  
Elena V. Negodaeva
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Postoperative Period ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Pulmonary Complications ◽  
Control Group ◽  
First Year ◽  
Hospitalization Period ◽  
First Year Of Life

The purpose of the study is to substantiate the use of dynamic electronic neurostimulation as a means of preventing broncho-pulmonary complications with children of the first year of life with congenital heart disease in the early postoperative period. Material and methods. There have been observed 82 children operated on congenital heart disease at an average age of 7.6 2.0 months old. By simple randomization, the patients were divided into two groups. Children who received the dynamic electronic neurostimulation procedure from the first day against the background of basic drug therapy were in the 1st group (40 people). The 2nd group (42 people) included patients who were treated only with basic medication. Results. The result analysis of the study showed a statistically significant effect in the use of dynamic electronic neurostimulation compared to the control group. By evaluating the length of the patients stay in hospital after the operative treatment, significant differences have also been obtained. Thus, the patients in the control group stayed in the unit for an average of 14.6 0.3 days, while the patients in the group where dynamic electronic neurostimulation was used in combination with basic therapy had a hospitalization period of 13.4 0.4 days (p 0.05). The use of DENS allowed to reduce the frequency of complications associated with the bronchopulmonary system starting from 34 days of the postoperative period. Thus, in the control group, 5 (11%) children showed pneumonia, 13 (30%) showed atelectasis or dystelectasis, 23 (55%) showed tracheobronchitis, while in the main group 2 (5%), 6 (15%) and 11 (27.5%) children, respectively. Conclusion. The obtained results of the work show the expediency of including dynamic electronic neurostimulation in the complex of medical and rehabilitation measures in early post-operative period with infants suffering from congenital heart disease.

scholarly journals Atrial Septal Defect - A New Perspective on the Cardiac Dyspnea

2018 ◽  
Vol 15 (2) ◽  
pp. 53-57
Author(s):  
Larisa Renata Roșan ◽  
Vlad Alin Pantea ◽  
Otilia Anca Ţica ◽  
Ovidiu Ţica ◽  
Mădălina Ioana Moisi ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Congenital Heart ◽  
Septal Defect ◽  
First Year ◽  
Cardiac Diseases ◽  
Embryological Development ◽  
Heart Malformation ◽  
New Perspective ◽  
First Year Of Life ◽  
Previous Medical History

AbstractThe congenital cardiac diseases predominately affect the children, as well as the young adults, and they are the consequence of an abnormal embryological development.Atrial septal defect (DSA) is a congenital heart malformation, which can close in the first year of life, being shown by the presence of a communication between the left atrium and right atrium with the left-to-right shunt, and it subsequently produces some complications.We report the case of a 31 years-old-female without previous medical history, who was diagnosed with atrial septal defect.

scholarly journals Parental experience of the neuromotor development of children with congenital heart disease: an exploratory qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elena Mitteregger ◽  
Martina Wehrli ◽  
Manuela Theiler ◽  
Jana Logoteta ◽  
Irina Nast ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Qualitative Study ◽  
Motor Development ◽  
Congenital Heart ◽  
Healthcare Professionals ◽  
Qualitative Content Analysis ◽  
First Year ◽  
First Year Of Life ◽  
Neuromotor Development

Abstract Background Children with severe congenital heart disease (CHD) are a group of children at risk for neurodevelopmental impairments. Motor development is the first domain to show a delay during the first year of life and may significantly contribute to parental concerns, stress, and difficulties in early child-parent attachment. Thus, the aim of the study was to better understand the wishes and concerns of parents of children with CHD and explore their experience of their children’s neuromotor development in the first year of life. Methods In this qualitative study, fourteen families were recruited. Their children were aged 1–3 years and had undergone open heart surgery within the first 6 months of life. Semi-structured interviews were audio-recorded and transcribed. The data was explored within an expert group, and a qualitative content analysis was conducted using VERBI MAXQDA software 2020. The study was conducted in accordance with the COREQ checklist. Results Parents of children with CHD reported several burdens and needs. Parental burdens concerned the child’s motor development, their own physical and psychological strain, and difficulties in communication with healthcare professionals. The needs, parents reported included supporting their child’s motor development, a medical coordinator, and better communication between healthcare professionals and parents. During the first phase of their children’s illness, parents underwent a dynamic transitional phase and expressed the need to rely on themselves, to trust their children’s abilities, and to regain self-determination in order to strengthen their self-confidence. Conclusions It is essential to involve parents of children with CHD at an early stage of decision-making. Parents are experts in their children and appreciate medical information provided by healthcare professionals. Interprofessional teamwork, partnering with parents, and continuous support are crucial to providing the best possible care for children and their families. Family-centred early motor intervention for CHD children might counteract the effect of parental overprotection and improve children’s motor development and thus strengthen child-parent interaction. In future work, we aim to evaluate a family-centred early motor intervention for children with CHD developed on the basis of this qualitative study. Trial registration Not applicable.

scholarly journals Bivalirudin Use in an Infant With Persistent Clotting on Unfractionated Heparin

2011 ◽  
Vol 16 (2) ◽  
pp. 108-112
Author(s):  
Katherine M. Malloy ◽  
Tara A. McCabe ◽  
Robert J. Kuhn
Keyword(s):  
Unfractionated Heparin ◽  
Pediatric Population ◽  
Coronary Intervention ◽  
Thrombin Inhibitors ◽  
Thrombin Inhibitor ◽  
Direct Thrombin Inhibitors ◽  
First Year ◽  
Heparin Infusion ◽  
Percutaneous Coronary ◽  
First Year Of Life

ABSTRACT Bivalirudin is a direct thrombin inhibitor approved for use in adult patients with heparin-induced thrombocytopenia (HIT) undergoing percutaneous coronary intervention. Recently, its use in the pediatric population has increased due to its anti-thrombin-independent mechanism of action. As heparin products produce great inter- and intraindividual variability in pediatric patients, often due to decreased anti-thrombin concentrations in the first year of life, some practitioners have turned to direct thrombin inhibitors, such as bivalirudin, for more predictable pharmacokinetics and effects on bound and circulating thrombin. We report our experience using bivalirudin in a 2-month-old female with recurrent systemic thrombi despite continuous unfractionated heparin infusion. Due to the patient's inability to maintain therapeutic activated partial thromboplastin time (aPTT) values during heparin infusion, bivalirudin was initiated at 0.1 mg/kg/h and increased due to subtherapeutic aPTTs to a maximum of 0.58 mg/kg/h. Therapeutic aPTTs were achieved at the increased dose; however, the patient's worsening renal impairment with resultant drug accumulation and overwhelming sepsis on day 5 of therapy led to discontinuation of the infusion and the initiation of comfort measures.

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