scholarly journals Facts about the General Medical Care of Adults with Congenital Heart Defects: Experience of a Tertiary Care Center

2020 ◽  
Vol 9 (6) ◽  
pp. 1943
Author(s):  
Lavinia Seidel ◽  
Kathrin Nebel ◽  
Stephan Achenbach ◽  
Ulrike Bauer ◽  
Peter Ewert ◽  
...  
Keyword(s):  
Heart Disease ◽  
Medical Care ◽  
Primary Care Physicians ◽  
Congenital Heart ◽  
Heart Defects ◽  
Care Center ◽  
Tertiary Care ◽  
Care Practice ◽  
Cross Sectional ◽  
Almost All

Background: Due to the increase in survival rates for congenital heart disease (CHD) in the last decades, over 90% of patients today reach adulthood. Currently, there are more than 300,000 adults with CHD (ACHD) living in Germany. They have an increased need for specialized medical care, since almost all ACHD have chronic heart disease and suffer from specific chronic symptoms, risks, and sequelae. Primary care physicians (PCPs) play a crucial role in referring patients to ACHD specialists or specialized institutions. This cross-sectional study is intended to clarify the real-world care of ACHD from the PCP’s perspective. Methods: This analysis, initiated by the German Heart Centre Munich, was based on a 27-item questionnaire on actual ACHD health care practice in Germany from the PCP’s perspective. Results: In total, 767 questionnaires were considered valid for inclusion. The majority of the PCPs were general practitioners (95.9%), and 84.1% had cared for ACHD during the past year. A majority (69.2%) of the PCPs had cared for patients with simple CHD, while 50.6% and 33.4% had cared for patients with moderate and severe CHD, respectively, in all age groups. PCPs treated almost all typical residual symptoms and sequelae, and advised patients regarding difficult questions, including exercise capacity, pregnancy, genetics, and insurance matters. However, 33.8% of the PCPs did not even know about the existence of certified ACHD specialists or centers. Only 23.9% involved an ACHD-specialized physician in their treatment. In cases of severe cardiac issues, 70.8% of the PCPs referred patients to ACHD-certified centers. Although 52.5% of the PCPs were not sufficiently informed about existing structures, 64.2% rated the current care situation as either “very good” or “good”. Only 26.3% (n = 190) of the responding physicians were aware of patient organizations for ACHD. Conclusions: The present study showed that the majority of PCPs are not informed about the ACHD care structures available in Germany. The need for specialized ACHD follow-up care is largely underestimated, with an urgent need for optimization to reduce morbidity and mortality. For the future, solutions must be developed to integrate PCPs more intensively into the ACHD care network.

Fetal echocardiography in Lithuania: traditions, significance and problems

2010 ◽  
Vol 17 (3-4) ◽  
pp. 116-122
Author(s):  
Ramunė VANKEVIČIENĖ
Keyword(s):  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Fetal Echocardiography ◽  
Heart Defects ◽  
Tertiary Care ◽  
Congenital Heart Diseases ◽  
Conduction Disturbances ◽  
Tertiary Care Centers ◽  
Almost All

Background. The discovery of ultrasound has made a revolution in almost all fields of medicine. The past three decades have withessed an intensive development of fetal echocardiography methods and technique. The aim of the paper is to present a review of the results and trends of the last 10 years of fetal echocardiography in Lithuania and to show the spectrum and outcomes of prenatally detected congenital heart diseases. Materials and methods. Fetal echocardiography was performed for 1816 fetuses during the period from 1999 to 2009. Results. Cardiac pathology was diagnosed in 176 (9.7%) fetuses. Heart defects were detected in 112 (63.6%) of them, cardiac rhythm and conduction disturbances in 62 (35.2%), cardiomyopathy in 2 (1.1%) fetuses, and heart rhabdomyoma in 1 (0.6%) fetus. The general rate of the postnatal diagnosis of congenital heart defects in Lithuania was about 10%. Most of fetal cardiac diseases (70.5%) were diagnosed after 22 weeks of gestation. Because most of antenatally diagnosed congenital heart defects (74%) were critical and inconsistent with life, a large part of newborns (40.2%) died in the neonatal period, 10.7% of fetuses died in utero, and 8% of pregnancies were terminated by abortion. The data demonstrate good tendencies: the diagnosis has become earlier, a wider spectrum of diseases have been diagnosed, more newborns have survived. Our survey shows that 41.1% of newborns with prenatally diagnosed congenital heart defects have survived. Conclusions. 10% of severe congenital heart diseases are detected prenatally in Lithuania. The efficacy of antenatal diagnostics depends on the qualification of specialists, the number of tertiary care centers, on a successful collaboration among pediatric cardiologists, obstetricians and geneticists. The main problem is an insufficient preparation of obstetricians, the uncertified favor of pediatric cardiologist. Keywords: congenital heart disease, fetal echocardiography, antenatal diagnostics

scholarly journals An assessment of the pattern of congenital heart disease in children: study in a tertiary care hospital, Rajshahi, Bangladesh

2020 ◽  
Vol 8 (1) ◽  
pp. 1
Author(s):  
Kuntal Roy ◽  
Humayun Shahed ◽  
Kaushik Roy ◽  
Quazi Sahely Sarah ◽  
Nandita Sur Chowdhury
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Structural Abnormality ◽  
Lung Field ◽  
Care Hospital ◽  
Cross Sectional ◽  
Multiple Lesions

Background: Congenital heart disease is defined as a gross structural abnormality of the heart or intrathoracic great vessels that is actually or potentially of functional significance. The aim of this study was to assess the pattern of congenital heart disease.  Methods: It was a hospital based Cross-sectional study carried out prospectively in the department of pediatrics of Rajshahi medical college and hospital from July 2011 to December 2011. The study population was all the children up to 12 years of age admitted in three pediatric units of this hospital during the study period.Results: Among the 147 clinically suspected cases congenital heart disease was confirmed in 110 cases by echocardiography. Thrill was mostly present in 60.5% of VSD cases, in 42.1% of PDA, in 50% of A-V canal defect and 10% of multiple lesions patients. Palpable P2 was present in 27.9% of VSD cases, 15% of TOF, 50% of PS and 30% of multiple lesions patients. Left parasternal heave was found in 25.6% of VSD cases, 15.6% of ASD, 88.2% of TOF, 50% of PS and 40% of multiple lesions patients. Cardiomegaly was present in 5.3% of PDA, 50% of COA, 50% of PS and 20% of multiple lesions cases. Plethoric lung field with cardiomegaly & consolidation was observed in 10% of VSD and 21% of PDA cases. Cardiomegaly with consolidation was observed in 11.6% of VSD & 15.6% of ASD cases. Boot shape heart with oligamic lung was observed in 88.2% of TOF patients. Pulmonary opacity/consolidation was found in 4.7% of VSD cases.Conclusions: It appeared that incidence of CHD is quite significant in RMCH.

scholarly journals PREVALENCE OF CONGENITAL HEART DISEASE IN UMERKOT

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S824-27
Author(s):  
Mohsin Saif ◽  
Abdul Fatah ◽  
Waqas Akhtar ◽  
Farah Javed ◽  
Ali Mujtaba Tahir ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Ventricular Septal Defect ◽  
Tetralogy Of Fallot ◽  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Defects ◽  
Cross Sectional ◽  
Male Preponderance

Objective: To study the prevalence and the pattern of distribution of congenital heart disease.Study Design: Descriptive cross-sectional study.Place and Duration of Study: The study was conducted at outpatient department (OPD) of CMH Chhor and DHQ Umerkot, Sindh (Pakistan), from Dec 2019 to Mar 2020.Methodology: All the children (<12 years age) presenting to Paediatric OPD of the two hospitals were enrolled into study. Any patient with either a history or clinical examination pointing towards a suspected congenital heart disease was referred to Paediatric Cardiologist for 2-D echocardiogram. Details of the patient were recorded on designated proforma. Results: A total of 273 patients were diagnosed with congenital heart disease. Out of these, 114 (41.7%) were female and 159 (58.2%) were male (male: female of 1.4:1). The age of the children was ranging from 2 months to 12 years, 153 (56.04%) had simple heart defects, while 120 (43.9%) had complex or multiple congenital heart anomalies. Amongst the 273 patients, 25.3% were cyanotic and 74.7% had acyanotic heart disease. Most common lesion identified was ventricular septal defect (29.6%), followed by Tetralogy of Fallot in 20.8%. Conclusion: Acyanotic heart defects confirms to the major bulk of congenital heart defects with male preponderance.

scholarly journals Patterns of Rheumatic Heart Disease and Treatment Practices at Tertiary Care Center in Nepal: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (230) ◽  
Author(s):  
Rajesh Nepal ◽  
Madhab Bista ◽  
Sahadeb Prasad Dhungana
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Tertiary Care Center ◽  
Sectional Study ◽  
Cross Sectional ◽  
Treatment Practices ◽  
Rheumatic Heart

Introduction: Rheumatic heart disease is a sequel of rheumatic fever which causes heart valve damage. This study was conducted to look at the pattern of valve lesions and treatment practices in patients with rheumatic heart disease. Methods: A cross-sectional study conducted at the tertiary care center with a diagnosis of rheumatic heart disease from July 2018 to January 2020 by convenient sampling. Ethical clearance was obtained from the Institutional Review Committee (ref no. 55/2018). Data were analyzed by using Statistical package for social sciences version 20. Results: Out of 600 patients, 428 (71.3%) were female. The mean age was 44.24±14.24 years. The isolated mitral valve was affected in 280 (46.6%). Dual involvement of mitral and aortic valve was present in 294 (49%). Only 14 (2.3%) had involvement of isolated aortic valve involvement. Overall, mitral stenosis was the most common abnormality 508 (84.6%) followed by mitral regurgitation 418 (69.6%), aortic regurgitation 320 (53.3%), and aortic stenosis 63 (10.5%). Assessment of the severity of lesions showed that 247 (41.2%) patients had severe mitral stenosis, 119 (19.8%) severe mitral regurgitation, 14 (2.3%) severe aortic stenosis, and 11 (1.8%) severe aortic regurgitation. Majority 493 (82.2%) were treated with medical therapies. Surgical procedures were performed in 51 (8.5%). The use of anticoagulation was in 212 (35.3%) of eligible patients. Conclusions: Mitral valve was affected commonly both in isolation and combination. The majority of patients who were eligible for cardiac interventions were treated medically with suboptimal use of anticoagulation and secondary prophylaxis.

To Determine the Frequency of Congenital Heart Disease in Infants of Diabetic Mothers

2021 ◽  
Vol 15 (9) ◽  
pp. 2270-2271
Author(s):  
Iqrar Hussain ◽  
Syed Sajid Munir ◽  
Maimoona Saeed ◽  
Sami Ul Haq
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Teaching Hospital ◽  
Congenital Heart ◽  
Heart Defects ◽  
Keywords Diabetes ◽  
Cross Sectional ◽  
Special Care Baby Unit ◽  
Margin Of Error ◽  
Diabetic Mothers

Aim: To determine the frequency of Congenital Heart Disease in infants of diabetic mother. Methodology: Cross sectional (Descriptive) study conducted in the Department of Pediatrics Special Care Baby Unit (SCBU) Khyber Teaching Hospital Peshawar from 15-04-2015 to 15-10-2015. The sample size was150 patients, using 52.5% incidence of CHD in IDM and 95% confidence interval with 8% margin of error under WHO software Results: This study was carried out on 150 patients at the Department of Pediatrics, Khyber Teaching Hospital Peshawar. CHD was detected in 79 (52.7%) patients while in 71 (47.33%) patients, CHD was not detected. Conclusion: Our study concluded moderate prevalence of Congenital Heart Disease in infants born to diabetic mothers. Keywords: Diabetes mellitus, Pregnancy, Newborn, Heart defects

Frequency and types of congenital heart disease in neonates: A cross-sectional study from large public sector hospital of Karachi, Pakistan

2020 ◽  
Vol 13 (4) ◽  
pp. 163-165
Author(s):  
Misbah Majeed ◽  
Muhammad Ashfaq ◽  
Bader U Nisa ◽  
Aijaz Ahmed ◽  
Jai Parkash
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Septal Defect ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Transposition Of Great Arteries

Background: Congenital heart disease (CHD) is one of the frequent congenital health issues in neonates. Early diagnosis is a key factor to combat this problem. This study aims to assess the frequency and common types of CHD among neonates presenting to a tertiary care hospital, Karachi. Patients and methods: This descriptive cross-sectional study was conducted in a Neonatal Intensive Care Unit (NICU) of National Institute of Child Health (NICH), Karachi from March to September 2017. All neonates of gestational age ≥37 weeks with suspected CHD (presence of blue-tinged skin, i.e. cyanosis on routine clinical examination) were included. Information regarding presence of CHD and its types were collected along with the demographic characteristics and history of the patients. Results: Of 134, frequency of CHD was observed in 126 (94%) patients. Out of these 126 CHD patients, Ventricular septal defect (VSD) was observed in 49 (38.9%), patent ductal arteriosus (PDA) in 29 (23%), atrial septal defect (ASD) was observed in 19 (15.1%), Transposition of great arteries (TGA) in 18 (14.3%), and tetralogy of Fallot (TOF) in 14 (11.1%) patients. A significant association of VSD was observed with neonatal age (p = <0.001), ASD with neonatal age (p = 0.037) and maternal age (p = 0.025), while TGA was found significantly associated with neonatal age (p<0.001). Conclusion: CHD was observed in majority of the suspected patients with VSD as commonest type of congenital heart diseases among neonates.

Persistent left superior vena cava accompanying congenital heart disease in children: Experience of a tertiary care center

2017 ◽  
Vol 34 (3) ◽  
pp. 436-440 ◽  
Author(s):  
Mehmet Emre Ari ◽  
Vehbi Doğan ◽  
Senem Özgür ◽  
Özben Ceylan ◽  
İlker Ertuğrul ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Superior Vena ◽  
Care Center ◽  
Tertiary Care ◽  
Vena Cava ◽  
Tertiary Care Center ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena

scholarly journals Mortality profile of confirmed cases of swine flu attending a tertiary care center of Udaipur region of Rajasthan, India

2019 ◽  
Vol 6 (3) ◽  
pp. 906
Author(s):  
Yogesh Kumar Singhal ◽  
Nitin Kothari
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Influenza A ◽  
Care Center ◽  
Tertiary Care ◽  
Case Fatality ◽  
Swine Flu ◽  
Cross Sectional ◽  
Influenza A H1n1

Background: Mortality profile is an analytical tool used to identify the various factors responsible for poor outcome of disease and it can also use to evaluate quality and efficiency of healthcare providers. The aim of this study is to summarise the clinical and epidemiological factors as well as to identify the risk factors associated with mortality among swine flu cases.Methods: It is a cross-sectional, descriptive, hospital-based study conducted on 62 deceased patients due to swine flu reported at Maharana Bhupal Government Hospital, Udaipur, Rajasthan during the outbreak of influenza A H1N1 in the year 2015. A standardized pre-structured questionnaire with consent was filled by help of bed head tickets and by interview of attendants of deceased patients.Results: Deaths were higher among age group of 31-45 years (35.48%). Case fatality rate for male patients (13.88%) was higher. Mortality was highest in females of rural background 27(43.55%). Majority of deceased patients (70.97%) had delay of 4-7 days in admission after onset of symptoms. Diabetes, cardiovascular diseases and pregnancy was the major risk factors for poor outcome.Conclusions: Delay in diagnosis and admission may be the reason for higher mortality rate. The most common co morbid illness was Diabetes mellitus, cardiovascular diseases (Ischemic heart disease, Rheumatic heart disease, Hypertension) and pregnancy.

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