scholarly journals Spinal Anesthesia in Patient with Congestive Heart Failure due to Congenital Atrial Septal Defect, and Pulmonary Hypertension Undergoing Cesarean Section Procedure: A Case Report

2020 ◽  
Vol 1 (2) ◽  
pp. 95-102
Author(s):  
Anugerah Ade Periambudi ◽  
Rizal Zainal ◽  
Mayang Indah Lestari
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Case Report ◽  
Atrial Septal Defect ◽  
Spinal Anesthesia ◽  
Congenital Heart ◽  
Septal Defect ◽  
Shortness Of Breath

Introduction. In patients suffering from heart disease, pregnancy is a risk factor for mortality. Heart disease in pregnant women can be in form of rheumatic heart disease, cardiomyopathy, or congenital heart disease. This case report is about the successful spinal anesthesia technique in cesarean section (C-section) patients with congestive heart failure due to congenital atrial septal defect, and pulmonary hypertension (PH). Case presentation. A pregnant woman, 24 years old, planned to have an emergency C-section. She complained about shortness of breath for 2 days before admission. Three months ago, the patient started to feel shortness of breath during activity and also complained her legs swelled. She has a history of congenital heart i.e. atrial septal defect (ASD), but not routinely been treated. Her examination showed tachypnea, murmur, bibasilar fine crackles lung sound, and pretibial pitting edema. Echocardiography showed ASD with pulmonary hypertension. Spinal Anesthesia using 0.5% isobaric bupivacaine 7.5 mg and fentanyl 25 µcg was given before surgery. Drugs was injected in L3-L4 level with the upper target was as high as T6. the head position is raised 30 degrees. Procedure went well and the APGAR score was 8/9, Patient was admitted to the ICU for one day and discharged from hospital at the 5 days of hospital care. Conclusion. Spinal single-shot spinal anesthesia with small doses of bupivacaine and adjuvant can be used as an alternative technique in emergency C-section for patients with congestive heart failure due to congenital atrial septal defect, and pulmonary hypertension.

scholarly journals Spinal Anesthesia in Patient with Congestive Heart Failure due to Congenital Atrial Septal Defect, and Pulmonary Hypertension Undergoing Cesarean Section Procedure: A Case Report

2021 ◽  
Vol 1 (2) ◽  
pp. 95-102
Author(s):  
Anugerah Ade Periambudi ◽  
Rizal Zainal ◽  
Mayang Indah Lestari
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Case Report ◽  
Atrial Septal Defect ◽  
Spinal Anesthesia ◽  
Congenital Heart ◽  
Septal Defect ◽  
Shortness Of Breath

Introduction. In patients suffering from heart disease, pregnancy is a risk factor for mortality. Heart disease in pregnant women can be in form of rheumatic heart disease, cardiomyopathy, or congenital heart disease. This case report is about the successful spinal anesthesia technique in cesarean section (C-section) patients with congestive heart failure due to congenital atrial septal defect, and pulmonary hypertension (PH). Case presentation. A pregnant woman, 24 years old, planned to have an emergency C-section. She complained about shortness of breath for 2 days before admission. Three months ago, the patient started to feel shortness of breath during activity and also complained her legs swelled. She has a history of congenital heart i.e. atrial septal defect (ASD), but not routinely been treated. Her examination showed tachypnea, murmur, bibasilar fine crackles lung sound, and pretibial pitting edema. Echocardiography showed ASD with pulmonary hypertension. Spinal Anesthesia using 0.5% isobaric bupivacaine 7.5 mg and fentanyl 25 µcg was given before surgery. Drugs was injected in L3-L4 level with the upper target was as high as T6. the head position is raised 30 degrees. Procedure went well and the APGAR score was 8/9, Patient was admitted to the ICU for one day and discharged from hospital at the 5 days of hospital care. Conclusion. Spinal single-shot spinal anesthesia with small doses of bupivacaine and adjuvant can be used as an alternative technique in emergency C-section for patients with congestive heart failure due to congenital atrial septal defect, and pulmonary hypertension.

scholarly journals Predictor factors of pulmonary hypertension in children with left-to-right shunting in acyanotic congenital heart disease

2021 ◽  
Vol 61 (3) ◽  
pp. 119-24
Author(s):  
Weny Inrianto ◽  
Indah Kartika Murni ◽  
Ida Safitri
Keyword(s):  
Heart Failure ◽  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Iron Deficiency ◽  
Congenital Heart ◽  
Septal Defect ◽  
Deficiency Anemia ◽  
Acyanotic Congenital Heart Disease ◽  
Hypertension In Children

Background Left-to-right shunting in acyanotic congenital heart disease (CHD) is the most common type of defect in childhood heart disease. Limited access to specialist health services causes delays in CHD management. In limited resource settings, identification of factors that influence the occurrence of pulmonary hypertension is important in order to decide which patients should be prioritized for defect closure to prevent further complications. Objective To determine predictive factors of pulmonary hypertension after a left-to-right shunt CHD diagnosis. Methods This retrospective cohort study included children aged 1 month to 17 years with isolated atrial septal defect, or ventricular septal defect, or patent ductus arteriosus. Potential predictors studied were iron deficiency anemia, mitral regurgitation, pneumonia, and heart failure. Bivariate analysis was done with Chi-square test and multivariate analysis was done with Cox regression to determine the hazard ratio. Results Pulmonary hypertension occurred in 68 of 176 subjects. Iron deficiency anemia, mitral regurgitation, and pneumonia were not predictives of pulmonary hypertension. However, heart failure was a significant predictive factor for pulmonary hypertension, with a hazard ratio of 4.1 (95%CI 2.2 to 7.5; P=0.001). Conclusions Heart failure is a predictive factor of pulmonary hypertension in children with left-to-right shunting in acyanotic CHD.

scholarly journals Severe pulmonary hypertension and reduced right ventricle systolic function associated with maternal mortality in pregnant uncorrected congenital heart diseases

2019 ◽  
Vol 9 (4) ◽  
pp. 204589401988451 ◽  
Author(s):  
Anggoro B. Hartopo ◽  
Dyah W. Anggrahini ◽  
Detty S. Nurdiati ◽  
Noriaki Emoto ◽  
Lucia K. Dinarti
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Mortality Rate ◽  
Right Ventricle ◽  
Maternal Mortality ◽  
Atrial Septal Defect ◽  
Congenital Heart ◽  
Septal Defect ◽  
Systolic Function

Background Pregnant uncorrected congenital heart disease patients, especially those who already developed pulmonary hypertension, have increased risk for maternal mortality. The pulmonary hypertension severity and right ventricle function may be associated with higher maternal mortality. The study aimed to investigate the mortality rate of pregnant uncorrected congenital heart disease and the impact of pulmonary hypertension severity on mortality. Methods This is the sub study of COngenital HeARt Disease in adult and Pulmonary Hypertension Registry. The data of pregnant uncorrected congenital heart disease patients were analyzed from registry database. The maternal mortality was recorded. The data of demography, clinics, obstetrics, and transthoracic echocardiography were collected. The factors that influenced maternal mortality were analyzed. A statistical significance was determined when p value < 0.05. Results From 2012 until 2017, there were 78 pregnant congenital heart disease patients. Of them, 56 patients were eligible for analyses. The majority of congenital heart disease was atrial septal defect (91.1%). The maternal mortality rate was 10.7% (6 of 56). Pulmonary hypertension occurred in 48 patients, therefore the maternal mortality rate among congenital heart disease-pulmonary hypertension with majority of atrial septal defect was 12.5% (6 of 48). Among nonsurvivors, 100% suffered from severe pulmonary hypertension as compared to survivors (56.0%), p = 0.041. Most nonsurvivors were Eisenmenger syndrome (83.3%), significantly higher compared to survivors (22.0%), p = 0.006. Nonsurvivors had significantly worsened WHO functional class, reduced right ventricle systolic function, and right heart failure. The modes of maternal death were severe oxygen desaturation (66.7%) and respiratory failure and sepsis (33.3%). Most of the maternal deaths occurred within 24 h postpartum period. Conclusion Maternal mortality rate among pregnant uncorrected congenital heart disease with majority of atrial septal defect was 10.7% and among congenital heart disease-pulmonary hypertension with majority of atrial septal defect was 12.5%. Factors related with maternal mortality were severe pulmonary hypertension, Eisenmenger syndrome, and reduced right ventricle systolic function.

Late Surgical Closure of Secundum Type Atrial Septal Defect

1996 ◽  
Vol 4 (3) ◽  
pp. 164-167
Author(s):  
Binali Mavitaş ◽  
S Fehmi Katircioğlu ◽  
Birol Yamak ◽  
Ahmet Saritaş ◽  
Gürkan Uzunonat ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Congestive Heart Failure ◽  
Pulmonary Hypertension ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Surgical Closure ◽  
Long Term Follow Up

Between 1968 and 1995, a total of 153 patients who were between 35 and 63 years of age (mean 49.8 years), underwent surgery for secundum type atrial septal defect. There were 78 (50.9%) males and 75 females (49.1 %). Mean left-to-right shunt ratio was calculated as 2.49. Mean pulmonary artery pressure was 50.15 mm Hg. Three patients died within 30 days of surgery, giving a hospital mortality of 1.96%. Long-term follow-up was available in 135 cases (90%). Total follow-up was 967.3 patient-years and ranged from 3 months to 11.3 years (mean 7.16 years). There were no late deaths reported. Four patients were readmitted with atrial fibrillation and 2 with pericardial effusion. In our experience, surgical closure of atrial septal defect in adults was found to be successful, safe, and with low morbidity in patients with pulmonary hypertension and congestive heart failure.

scholarly journals A case of atrial septal defect presenting with recurrent syncope

2021 ◽  
Vol 16 (2) ◽  
pp. 90-93
Author(s):  
Seng Wee Cheo ◽  
Qin Jian Low
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Atrial Septal Defect ◽  
Congenital Heart ◽  
Septal Defect ◽  
Adult Population ◽  
Eisenmenger Syndrome ◽  
Progressive Dyspnoea

Atrial septal defect (ASD) is a congenital heart disease often encountered in the adult population, as it is frequently asymptomatic in childhood. In untreated patients with ASD, some may go on to develop complications such as atrial arrythmias, pulmonary hypertension and Eisenmenger syndrome. Pulmonary hypertension is seen in 6 – 35% of this group of untreated patients in adulthood as a result of left-to-right shunting. Symptoms of pulmonary hypertension include progressive dyspnoea, ascites and syncope. Here, we would like to illustrate a case of ASD presenting with recurrent syncopal attack.

scholarly journals Malignant Ventricular Arrhythmias After Surgery for Uncomplicated Congenital Atrial Septal Defect-Case Report

2020 ◽  
Author(s):  
Ying Liang ◽  
Yulong Guan
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Case Report ◽  
Atrial Septal Defect ◽  
Ventricular Arrhythmias ◽  
Congenital Heart ◽  
Septal Defect ◽  
Early Stage ◽  
Uneventful Recovery ◽  
Case Presentation

Abstract Background:Malignant ventricular arrhythmias (MVA) occurring subsequent to a repair of uncomplicated congenital heart disease is scarcely described in literature.Case presentation:One adult patient following congenital atrial septal defect (ASD) repair underwent immediate postoperative refractory MAV and ventricular fibrillation. The recurrent episodes of shocks cannot be suppressed by drugs. Emergent re-exploration was performed and repeated closure of ASD and DeVega's annuloplasty were completed. The patient had uneventful recovery and no occurrence of arrhythmia.Conclusion: Malignant ventricular arrhythmias are rare and should never be overemphasized even during the repair of uncomplicated congenital heart defect. Re-exploration should be taken into consideration when MVA occurred in the early stage postoperatively.

scholarly journals TRANSPOSISI ARTERI BESAR PADA DEWASA

2011 ◽  
Vol 35 (2) ◽  
pp. 181
Author(s):  
Deni Arisanti ◽  
Rony Yuliwansyah ◽  
Akmal Edi M Hanif ◽  
Yerizal Karani ◽  
Saharman Leman
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Pulmonary Hypertension ◽  
Mitral Regurgitation ◽  
Physical Examination ◽  
Septal Defect ◽  
Functional Class ◽  
Shortness Of Breath ◽  
Pitting Edema ◽  
Class Iv

AbstrakSeorang laki-laki umur 50 tahun dirawat di Emergensi Penyakit Dalam RSUP Dr. M. Djamil Padang dengan keluhan utama sesak nafas meningkat sejak 1 hari yang lalu. Sesak nafas semakin meningkat jika beraktifitas, dan berkurang jika istirahat dengan posisi bantal yang ditinggikan. Jika sesak nafas sering diikuti dengan bibir dan kuku yang membiru. Pasien sudah dikenal menderita penyakit jantung bawaan, awalnya lahir dengan kulit kebiruan dan mudah tersedak jika menyusu. Dari pemeriksaan fisik didapatkan: Clubbing finger, sianosis, peningkatan Vena Jugolaris, kardiomegali, dan pitting oedema. Dari laboratorium didapatkan: Hemoglobin: 17,1 gr/dl, Hematokrit : 62%, Ureum : 39 mg/dl, Kreatinin : 2,0 mg/dl, TKK :31, Echo Cardiography: Transposisi Arteri Besar, Large Ventrikel Septal Devect, trikuspit regurgitasi dengan hipertensi pulmonal dan moderat Mitral Regurgitasi. Pasien di diagnosa dengan Congestive Heart Failure Functional Class IV LVH- RVH, irama RBBB karena transposisi Arteri Besar dengan Ventrikel Septal Defek.Kata kunci: Transposisi Arteri Besar, Kelainan Jantung Bawaan.AbstractHas been treated a 50 years old man was hospitallized in Internal emengency Department of Dr. M. Djamil Hospital Padang with cief complaints of shortness of breath influenced activity, frequent night waking due to shortness of breath, and an elevated bed with a pillow. On physical examination found: clubbing, cyanosis, increased Jugolaris veins, cardiomegaly, and pitting edema. From the laboratium: Hemoglobin: 17,1 gr/dl, Hematokrit : 62%, Ureum : 39 mg/dl, Kreatinin : 2,0 mg/dl, TKK :31, Echo Cardiography shows: Transposition of the Great Arteries, Large Ventricle Septal Defect, Tricuspid Regurgitation with pulmonary hypertension, and moderate Mitral Regurgitation. Patients with definitife diagnosis: Congestive Heart Failure Functional Class IV LVH- RVH, RBBB rhythm Cause By Transposition of the Great Arteries with a Ventrikel Septal Defec.Key word : Transposition of the Great Arteries, Kongenital Heart Desease.

Congenital heart disease and pulmonary tuberculosis

Open Medicine ◽  
2010 ◽  
Vol 5 (2) ◽  
pp. 172-175
Author(s):  
Rana Olguntürk ◽  
F.Sedef Tunaoğlu ◽  
Levent Gökgöz ◽  
Leyla Memiş ◽  
Serdar Kula
Keyword(s):  
Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Respiratory Failure ◽  
Pulmonary Tuberculosis ◽  
Atrial Septal Defect ◽  
Tricuspid Valve ◽  
Congenital Heart ◽  
Septal Defect ◽  
Postmortem Examination

AbstractA 13-year-old boy with atrial septal defect and tricuspid valve abnormality was reported. He had crepitan ralles and signs of heart failure. He was treated with digital, diuretic and antimicrobial therapies. After clinical improvement he underwent surgery. The atrial septal defect was closed, and ringplasty was applied to the tricuspid valve. After the operation, he could not be extubated because of respiratory failure. On the seventh day following the surgery, he developed pneumothorax and hyportension and died. Postmortem examination showed bilateral diffuse pulmonary tuberculosis. The aim of this report is to emphasise the association of tuberculosis and congenital heart disease.

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