Cardiac evaluation in children with suspected heart disease. Preliminary results in 2000 patients.

1995 ◽  
Vol 71 (4) ◽  
pp. 209-213
Author(s):  
Fernando TV Amaral ◽  
Marcos A Nunes ◽  
João A Granzotti
Nutrition ◽  
2019 ◽  
Vol 61 ◽  
pp. 21-31 ◽  
Author(s):  
Hannah L. Mayr ◽  
Audrey C. Tierney ◽  
Teagan Kucianski ◽  
Colleen J. Thomas ◽  
Catherine Itsiopoulos

Author(s):  
Luc L. Mertens

The development of ultrasound technology to visualize cardiac structures, based on the pioneering work by Edler and Hertz at the University of Lund in Sweden, has literally created a revolution in the field of paediatric cardiology. Before the era of cardiac catheterization and echocardiography the diagnosis of congenital heart disease was mainly based on combining physical findings, cardiac auscultation, electrocardiogram (ECG), and chest X-ray. This was largely based on the work by Helen B. Taussig at John Hopkins in the 1930s who established the field of clinical paediatric cardiology by integrating pathology knowledge with clinical findings. Diagnosis at that time was based on clinical skills and was more an art than science. The introduction of paediatric cardiac surgery in the 1950s was made possible due to the simultaneous development of cardiac catheterization and angiography which allowed an accurate description of the different cardiac lesions and the associated haemodynamics prior to surgery. For a long period catheterization was the diagnostic gold standard and all surgical patients underwent an invasive cardiac evaluation. In the 1970s, echocardiography was developed as a clinical tool and due to its non-invasive nature, was introduced quickly in paediatric cardiology. As anatomical diagnosis is challenging by M-mode echocardiography, it was really the development of two-dimensional (2-D) echocardiography in the late 1970s and early 1980s that deeply influenced the field. For the first time the congenital defects could be imaged noninvasively and the 2-D images were extensively validated by comparing them with pathological and surgical findings. Adding pulsed, continuous, and colour Doppler data to the 2-D images resulted in a complete detailed description of congenital cardiac defects and their haemodynamic consequences. Further optimization of ultrasound technology specifically for paediatric imaging, such as the development of higher-frequency probes and increasing the standard grey-scale frame rates, further improved spatial and temporal resolution and overall image quality. Based on its excellent diagnostic accuracy and its non-invasive nature, echocardiography quickly became the primary non-invasive diagnostic technique for all children with heart disease. Currently every paediatric patient with suspected heart disease will undergo an echocardiographic examination as the first (and often only) diagnostic test.


2019 ◽  
Vol 90 (7) ◽  
pp. 792-795
Author(s):  
Shadi Yaghi ◽  
Andrew D Chang ◽  
Brittany A Ricci ◽  
Brian MacGrory ◽  
Shawna Cutting ◽  
...  

BackgroundThe aetiology of wall motion abnormalities (WMA) in patients with ischaemic stroke is unclear. We hypothesised that WMAs on transthoracic echocardiography (TTE) in the setting of ischaemic stroke mostly reflect pre-existing coronary heart disease rather than simply an isolated neurocardiogenic phenomenon.MethodsData were retrospectively abstracted from a prospective ischaemic stroke database over 18 months and included patients with ischaemic stroke who underwent a TTE. Coronary artery disease was defined as history of myocardial infarction (MI), coronary intervention or ECG evidence of prior MI. The presence (vs absence) of WMA was abstracted. Multivariable logistic regression was used to determine the association between coronary artery disease and WMA in models adjusting for potential confounders.ResultsWe identified 1044 patients who met inclusion criteria; 139 (13.3%, 95% CI 11.2% to 15.4%) had evidence of WMA of whom only 23 (16.6%, 95% CI 10.4% to 22.8%) had no history of heart disease or ECG evidence of prior MI. Among these 23 patients, 12 had a follow-up TTE after the stroke and WMA persisted in 92.7% (11/12) of patients. In fully adjusted models, factors associated with WMA were older age (OR per year increase 1.03, 95% 1.01 to 1.05, p=0.009), congestive heart failure (OR 4.44, 95% CI 2.39 to 8.33, p<0.001), history of coronary heart disease or ECG evidence prior MI (OR 27.03, 95% CI 14.93 to 50.0, p<0.001) and elevated serum troponin levels (OR 2.00, 95% CI 1.06 to 3.75, p=0.031).ConclusionIn patients with ischaemic stroke, WMA on TTE may reflect underlying cardiac disease and further cardiac evaluation may be considered.


2014 ◽  
Vol 16 (4) ◽  
pp. 245-255 ◽  
Author(s):  
Maggie C. Machen ◽  
Mark A. Oyama ◽  
Sonya G. Gordon ◽  
John E. Rush ◽  
Sarah E. Achen ◽  
...  

2015 ◽  
Vol 17 (S1) ◽  
Author(s):  
Agnes Mayr ◽  
Markus Holotta ◽  
Regina Esterhammer ◽  
Klemens Mairer ◽  
Gert Klug ◽  
...  

2004 ◽  
Vol 15 (4) ◽  
pp. 327-341 ◽  
Author(s):  
LINDSEY ALLAN

Ultrasound has been used in cardiac diagnosis since the 1960s. The original modality used was M-mode, which recorded the movement of heart structures relative to a single line of sound passed through the heart and was displayed as a paper tracing. During the 1970s, a two-dimensional image became possible, but it was a static image, which had limited value for cardiac evaluation. However, by the end of the 1970s, advances in ultrasound equipment allowed the heart to be displayed in real-time. This technology was applied initially in the adult and subsequently in the child. Echocardiography proved particularly suitable for children, partly because it is non-invasive and repeatable, but also because most heart disease in children is due to malformation of anatomical structure, which ultrasound can ideally display. At the same time, obstetric ultrasound was progressing rapidly and descriptions of the appearances of malformations in most fetal systems began to be published by the end of the 1970s. It was not until real-time equipment became generally available in obstetrics that the fetal heart could be satisfactorily evaluated. This led to descriptions by several authors of normal fetal cardiac anatomy as seen echocardiographically in 1980. The appearances of the echocardiogram in different forms of congenital heart disease (CHD) in children were published in the late 1970's, setting the stage for diagnosis in fetal life. As a result, by the mid-1980's, most major forms of CHD had been detected prenatally.


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