scholarly journals Cyanotic congenital heart disease: Impact on growth and endocrine functions.

2021 ◽  
Vol 28 (10) ◽  
pp. 1477-1483
Author(s):  
Muhammad Sohail Arshad ◽  
Waqas Imran Khan ◽  
Arif Zulqarnain ◽  
Hafiz Muhammad Anwar-ul-Haq ◽  
Mudasser Adnan
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Pulmonary Stenosis ◽  
Tertiary Care ◽  
Cyanotic Congenital Heart Disease ◽  
P Value ◽  
Common Diagnosis ◽  
Significant Difference ◽  
The Impact

Objective: To find out the impact of Cyanotic Congenital Heart Disease (CCHD) on growth and endocrine functions at a tertiary care child healthcare facility of South Punjab. Study Design: Case Control study. Setting: Department of Pediatric Cardiology and Department of Pediatric Endocrinology, Institute of Child’s Health (ICH), Multan, Pakistan. Period: December 2018 to March 2020. Material & Methods: During the study period, a total of 53 cases of Echocardiography confirmed CCHD were registered. Along with 53 cases, 50 controls during the study period were also enrolled. Height, weight, body mass index (BMI) along with hormonal and biochemical laboratory investigations were done. Results: There was no significant difference between gender and age among cases and controls (p value>0.05). Most common diagnosis of CCHD among cases, 24 (45.3%) were Tetralogy of Fallot (TOF) followed by 9 (17.0%) transposition of the great arteries (TGA) with Ventricular Septal Defect (VSD) with Pulmonary Stenosis (PS). Mean weight of CCHD cases was significantly lower in comparison to controls (21.19+6.24 kg vs. 26.48+8.1 kg, p value=0.0003). Blood glucose was significantly lower among cases in comparison to controls (77.58+14.58 mg/dl vs. 87.25+11.82 mg/dl, p value=0.0004). No significant difference was found in between cases and controls in terms of various hormone levels studied (p value>0.05) except Insulin-like Growth Factor-1 (IGF-1) levels (p value<0.0001). Conclusion: Children with cyanotic congenital heart disease seem to have negative effects on nutrition and growth. Change in pituitary-adrenal axis is suspected while pituitary-thyroid axis seemed to be working fine among CCHD cases. Serum glucose and IGF-1 levels were significantly decreased among CCHD cases.

scholarly journals Minute ventilation/carbon dioxide production in congenital heart disease

2021 ◽  
Vol 30 (161) ◽  
pp. 200178
Author(s):  
Alfred Hager
Keyword(s):  
Carbon Dioxide ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Minute Ventilation ◽  
Pulmonary Stenosis ◽  
Cardiopulmonary Exercise Testing ◽  
Carbon Dioxide Production ◽  
The Impact

This review summarises various applications of how ventilatory equivalent (ventilatory efficiency or better still ventilatory inefficiency) and the minute ventilation (VʹE)/carbon dioxide production (VʹCO2) slope obtained from cardiopulmonary exercise testing (CPET) can be used in the diagnostic or prognostic workup of patients with congenital heart disease.The field of congenital heart disease comprises not only a very heterogeneous patient group with various heart diseases, but also various conditions in different stages of repair, as well as the different residuals seen in long-term follow-up. As such, various physiologic disarrangements must be considered in the analysis of increased VʹE/VʹCO2 slope from CPET in patients with congenital heart disease. In addition to congestive heart failure (CHF), cyanosis, unilateral pulmonary stenosis and pulmonary hypertension (PH) provide the background for this finding. The predictive value of increased VʹE/VʹCO2 slope on prognosis seems to be more important in conditions where circulatory failure is associated with failure of the systemic ventricle. In cyanotic patients, those with Fontan circulation, or those with substantial mortality from arrhythmia, the impact of VʹE/VʹCO2 on prognosis is not that important.

Progressive pulmonary hypertension in cyanotic congenital heart disease with severe pulmonary stenosis

1996 ◽  
Vol 6 (3) ◽  
pp. 228-231
Author(s):  
Yiu-Fai Cheung ◽  
Maurice P. Leung ◽  
E. P. Wang
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Congenital Heart ◽  
Pulmonary Stenosis ◽  
Vascular Diseases ◽  
Double Outlet Right Ventricle ◽  
Cyanotic Congenital Heart Disease ◽  
Pulmonary Vasculature ◽  
Progressive Development

AbstractWe report the progressive development of pulmonary hypertension despite the presence of severe pulmonary stenosis in three patients with cyanotic congenital heart disease. The associated intracardiac lesions were complete transposition with a ventricular septal defect, double outlet right ventricle, and a heart with univentricular atrioventricular connection, respectively. Serial measurements on hemodynamics and histological findings documented the progression of pulmonary hypertension and pulmonary vascular diseases. The underlying etiology remains speculative. In view of the possibility of development of pulmonary hypertension despite a ‘protected’ pulmonary vasculature, corrective surgery should be contemplated as soon as technically feasible.

Impact of Anesthesia and Surgery for Congenital Heart Disease on the Vitamin D Status of Infants and Children

2013 ◽  
Vol 119 (1) ◽  
pp. 71-80 ◽  
Author(s):  
J. Dayre McNally ◽  
Kusum Menon ◽  
Pranesh Chakraborty ◽  
Lawrence Fisher ◽  
Kathryn A. Williams ◽  
...  
Keyword(s):  
Vitamin D ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Clinical Course ◽  
Tertiary Care ◽  
Vitamin D Status ◽  
Organ Systems ◽  
Vitamin D Levels ◽  
The Impact

Abstract Background: Vitamin D is recognized as a pleiotropic hormone important for the functioning of organ systems, including those central to critical illness pathophysiology. Recent studies have reported associations between vitamin D status and outcome among critically ill adults and children. Preoperative vitamin D status, impact of operative techniques, and relationship between immediate postoperative vitamin D levels and clinical course have not been described in the pediatric congenital heart disease (CHD) population. The objective of this study was to describe the impact of CHD surgery on vitamin D status and relationship between postoperative levels and clinical course. Methods: A prospective cohort study was conducted from 2009 to 2011 at a single tertiary care pediatric hospital. A total of 58 children with CHD were enrolled and blood collected preoperatively, intraoperatively, and postoperatively. Serum 25-hydroxyvitamin D (25OHD) was measured using liquid chromatography–mass spectrometry. Results: The mean preoperative 25OHD was 58.0 nm (SD, 22.4), with 42% being deficient (&lt;50 nm). Postoperatively, we identified a 40% decline in 25OHD to 34.2 nm (SD, 14.5) with 86% being deficient. Intraoperative measurements determined that initiation of cardiopulmonary bypass coincided with abrupt decline. CHD patients requiring catecholamines had lower postoperative 25OHD (38.2 vs. 26.5 nm, P = 0.007), findings confirmed through multivariate logistic regression. Lower postoperative 25OHD was associated with increased fluid requirements and intubation duration. Conclusions: Most CHD patients are vitamin-D deficient postoperatively due to low preoperative levels and a significant intraoperative decline. Interventional studies will be required to determine whether prevention of postoperative vitamin D deficiency improves outcome.

scholarly journals What do adult patients with congenital heart disease know about their disease, treatment, and prevention of complications? A call for structured patient education

Heart ◽  
2001 ◽  
Vol 86 (1) ◽  
pp. 74-80
Author(s):  
P Moons ◽  
E De Volder ◽  
W Budts ◽  
S De Geest ◽  
J Elen ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Adult Congenital Heart Disease ◽  
Tertiary Care ◽  
Educational Interventions ◽  
Heart Defect ◽  
The Impact

OBJECTIVETo assess how much adults with congenital heart disease understand about their heart defect, its treatment, and the preventive measures necessary to avoid complications.DESIGNDescriptive, cross sectional study.SETTINGAdult congenital heart disease programme in one tertiary care centre in Belgium.PATIENTS62 adults with congenital heart disease (47 men; 15 women), median age 23 years.MAIN OUTCOME MEASURESPatients' knowledge was assessed during an outpatient visit using the Leuven knowledge questionnaire for congenital heart diseases, a 33 item instrument developed for this study.RESULTSPatients had adequate knowledge (> 80% correct answers) about their treatment, frequency of follow up, dental practices, occupational choices, appropriateness of oral contraceptives, and the risks of pregnancy. Knowledge about the name and anatomy of the heart defect, the possibility of recurrent episodes of endocarditis during their lifetime, and the appropriateness of different physical activities was moderate (50–80% correct answers). There was poor understanding (< 50% correct answers) about the reasons for follow up, the symptoms of deterioration of the heart disease, the definition, characteristics, and risk factors of endocarditis, the impact of smoking and alcohol on the heart disease, the hereditary nature of the condition, and the suitability of intrauterine devices as contraceptives.CONCLUSIONSAdults with congenital heart disease have important gaps in their knowledge about their condition. The results of this study can be used as a basis for developing or optimising structured educational interventions to enhance patients' health behaviour.

scholarly journals Delayed Onset of Alcuronium Effect in Children with Cyanotic Congenital Heart Disease

1993 ◽  
Vol 21 (2) ◽  
pp. 197-200 ◽  
Author(s):  
J. P. Keneally ◽  
P. H. Goonetilleke ◽  
I. M. Ramzan
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Plasma Concentrations ◽  
Cyanotic Congenital Heart Disease ◽  
Disease Group ◽  
Normal Children ◽  
Significant Difference ◽  
Group A ◽  
Group B

The effect of alcuronium dichloride (0.3 mg/kg) was studied in seven normal children (Group A), nine with acyanotic congenital heart disease (Group B) and eight with cyanotic disease (Group C). The onset of action was recorded using an integrated electromyograph and blood samples taken for later estimation of plasma concentrations of the drug. The mean time (SD) taken to 75% suppression of twitch height was 1.3(0.8), 1.7(1.0) and 3.8(2.8) minutes, respectively, in each of the three groups. This was significantly slower in Group C compared with both other groups (P<0.05). While six of the Group A patients and seven from Group B reached 95 % paralysis within ten minutes, only two of the cyanosed children achieved this level of relaxation. However, if times to 95% relaxation were extrapolated, there was no significant difference between the groups at 4.5(3.9), 5.8(5.7) and 10.9(6.5) minutes respectively. There was a weak but statistically significant relationship between haematocrit and time to 75% blockade. Maximum twitch depression was similar in all three groups with plasma concentrations at this time being 1.6(0.7), 1.8(0.5) and 2.3(1.4) μg/ml respectively. Again, there was no statistically significant difference between these values. These results confirm that the clinical onset of relaxation is delayed in children with cyanotic congenital heart disease, possibly because of delayed distribution of alcuronium.

scholarly journals Comparison of Growth in Children with Cyanotic and Acyanotic Congenital Heart Disease in a Tertiary Care Hospital

2018 ◽  
Vol 36 (2) ◽  
pp. 64-69 ◽  
Author(s):  
Fahmida Chowdhury ◽  
Mujibul Hoque ◽  
Md Manajjir Ali ◽  
Md Anisul Hossain
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Growth Failure ◽  
Cyanotic Congenital Heart Disease ◽  
P Value ◽  
Z Score ◽  
Severe Stunting ◽  
Acyanotic Congenital Heart Disease ◽  
Weight For Age

Background: Congenital heart disease (CHD) is the commonest of all congenital lesions and is the most common type of heart diseases among children. Anthropometric evaluation is very important for early recognition of growth failure in children with cyanotic and acyanotic congenital heart diseases.Methods: This comparative cross sectional study was undertaken with the objective to compare the growth of children with cyanotic and acyanotic congenital heart disease using anthropometric measurement in Department of Paediatrics, Sylhet MAG Osmani Medical College Hospital from March, 2014 to September, 2014. Sixty children aged 6 months to 60 months with CHD, were included in this study, where 30 children with cyanotic and 30 children with acyanotic CHD, confirmed by Echocardiogram.Results: All the children (100%) with cyanotic congenital heart disease were underweight (Weight for age Z score). Among them, 23.33% had moderate and 76.67% had severe underweight. In children with acyanotic congenital heart disease, 93.33% had underweight. Among them, 20% had moderate and 73.33% had severe underweight. The p-value was 0.35008. In cyanotic congenital heart disease, 96.67% children had stunting. Among them, 13.33% had moderate and 83.33% had severe stunting. In acyanotic congenital heart disease, 43.33% children had stunting. Among them, 33.33% had moderate and 10% had severe stunting. There was significant statistical deference in between the two groups, (pvalue was <0.0001). In cyanotic congenital heart disease, 43.33% children had wasting. Among them, 30% had moderate and 13.33% had severe wasting. In acyanotic congenital heart disease, 76.67% children had wasting. Among them, 30% had moderate and 46.67% had severe wasting. There was significant deference in the groups (p value was 0.0077).Conclusion: Growth failure was common in children with both cyanotic and acyanotic congenital heart disease. There was no significant difference in weight for age Z score (WAZ) of patients with cyanotic and acyanotic CHD but stunting was significantly higher in patients with cyanotic CHD and wasting was significantly higher in patients with acyanotic CHD.J Bangladesh Coll Phys Surg 2018; 36(2): 64-69

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