scholarly journals CARDIAC EVALUATION IN NEWBORNS: AN ECHOCARDIOGRAPHY BASED STUDY

2021 ◽  
Vol 54 (1) ◽  
pp. 25-29
Author(s):  
Muhammad Sohail Arshad ◽  
Waqas Shakir ◽  
Hafiz Muhammad Anwar-ul-Haq ◽  
Mudasser Adnan ◽  
Munir Ahmad

Objective: To evaluate the cardiac status of newborns in terms of structural and functional heart diseases. Methodology: This descriptive study was conducted at Paediatric Cardiology Department of “The Children’s Hospital and The Institute of Child Health”, Multan, Pakistan, from January 2017 to December 2019. Neonates aged 0-28 days and referred for echocardiographic evaluation were enrolled. Diagnostic findings were confirmed with the assistance of echocardiography. We were focused on analyzing total number and types of heart diseases along with gender distribution during the study period. Results: During the study period, a total of 2729 newborns were evaluated. We noted 1523 (55.8%) newborns as structurally and functionally normal, 866 (31.7%) had congenital heart disease, 69 (2.5%) duct dependent lesions, 248 (9.1%) persistent pulmonary hypertension and 23 (0.8%) left ventricular (LV) dysfunction but with structurally normal heart. Newborns with LV dysfunction might have hypoxic myocardial damage, metabolic derangements or acute myocarditis. Ventricular Septal Defect (VSD) followed by Patent Ductus Arteriosus (PDA) and Atrial Septal Defect (ASD) were the most frequent types of acyanotic CHD observed in 248 (28.2%), 171 (19.7%) and 100 (11.5%) neonates respectively while Tetralogy of Fallot (TOF) was the most common type of cyanotic CHD 74 (8.5%). Conclusion: VSD followed by PDA, ASD and TOF were the most common types of CHD among neonates. Diagnosis of congenital heart defects in the early age is pointing towards improvement in healthcare facilities.

2020 ◽  
Vol 27 (11) ◽  
Author(s):  
Ahsan Beg ◽  
Nousheen Fatima ◽  
Abdul Razzaq Mughal

Objectives: To determine the spectrum of pediatric heart disease in a newly established cardiac centre in south Punjab. Study Design: Descriptive Observational Case Series. Setting: Department of Pediatric Cardiology of Cardiac Center Bahawal Victoria Hospital (BVH) Bahawalpur. Period: July 2019 to December 2019. Material & Methods: All consecutive patients of any gender, age range from first day of life to18 years, diagnosed as having heart disease (congenital/ acquired) on Echocardiography were enrolled. Patients of isolated bicuspid aortic valve, premature neonates having PDA or those who already had device or surgical intervention done were excluded from the study. The spectrum of the heart diseases in children was assessed by categorizing them as having acquired, acyanotic and acyanotic heart defects. Results: A total of 624 patients were enrolled in the study on the basis of inclusion criteria. There were 56.7 % male (n=354) while 43.3% were female (n=270) with male to female ratio 1.3:1. Majority of the patients were of infant age group (66%, n=412). Congenital heart disease (CHD) was present in 87% of the patients (n=543) while 13% (n=81) had acquired heart disease (AHD). Acyanotic heart lesions were found in 73.1% of patients while cyanotic congenital heart diseases (CCHD) were 26.9 %. Ventricular septal defect (VSD) was the most common CHD (33%), followed by Atrial Septal defect (14.9%) and Patent ductus arteriosus (13.1%). TOF was the most common CCHD (10.1%) followed by TGA (7.4%). Among AHD, 55.6% were of Rheumatic heart disease (RHD) followed by Cardiomyopathy (27.2), pericardial effusion (8.6%) and infective endocarditis (4.9%). Conclusion: The VSD, ASD, PDA, TOF and TGA remain the most common CHD in descending order while RHD is the most common acquired heart disease in children at our centre.


2016 ◽  
Vol 157 (21) ◽  
pp. 820-824
Author(s):  
István Hartyánszky ◽  
Sándor Varga ◽  
László Csepregi ◽  
Barna Babik ◽  
Judit Simon ◽  
...  

Introduction: The population with congenital heart disease is increasing and ageing. Aim: The aim of the authors was to examine the outcome of surgical management of congenital heart diseases beyond the age of 60 years. Method: Between 2013 and 2015, 77 adults were operated (36 younger, and 41 older than forty years, including 12 patients aged over 60 years. The numbers of procedures were as follows (in brackets the number of operations in the three age groups): Ross surgery 5 (3, 2, 0); aortic valve replacement 19 (12, 1, 6); subaortic membrane resection 1 (0, 0, 1); Bentall/ascending aortic plasty 8 (4, 3, 1); myectomy with or without mitral valve replacement in left ventricular outflow obstruction 5 (0, 3, 2); aortic coarctation 1 (1, 0, 0); ligation of ductus arteriosus 2 (1, 1, 0); reconstruction of right ventricular outflow tract with biological valve 4 (0, 3, 1); homograft 5 (5, 0, 0); BioValsalva graft 1 (0, 1, 0); primary reconstruction of complete atrioventricular septum defect 3 (1, 2, 0); valve replacement 2 (1, 1, 0); ventricular septum defect 10 (4, 6, 0); atrial septum defect closure 5 (2, 3, 0); total cavopulmonal anastomosis 1 (1, 0, 0); valve replacement in congenital transposition of great arteries 1 (0, 1, 0), Ebstein operation with valve plasty 2 (0, 1, 1); valve replacement 2 (1, 0, 1). Results: There was no operative mortality, while early mortality occurred in one patient with total cavopulmonal anastomosis due to multiorgan failure. Conclusions: Congenital heart defects can be operated beyond the age of 60 years with good results in a tertiary heart centre having great experience in the management of congenital and acquired heart disease. Orv. Hetil., 2016, 157(21), 820–824.


2014 ◽  
Vol 32 (2) ◽  
pp. 159-163 ◽  
Author(s):  
Felipe Alves Mourato ◽  
Lúcia Roberta R. Villachan ◽  
Sandra da Silva Mattos

OBJECTIVE:To determine the frequence and profile of congenital heart defects in Down syndrome patients referred to a pediatric cardiologic center, considering the age of referral, gender, type of heart disease diagnosed by transthoracic echocardiography and its association with pulmonary hypertension at the initial diagnosis.METHODS:Cross-sectional study with retrospective data collection of 138 patients with Down syndrome from a total of 17,873 records. Descriptive analysis of the data was performed, using Epi-Info version 7.RESULTS: Among the 138 patients with Down syndrome, females prevailed (56.1%) and 112 (81.2%) were diagnosed with congenital heart disease. The most common lesion was ostium secundum atrial septal defect, present in 51.8%, followed by atrioventricular septal defect, in 46.4%. Ventricular septal defects were present in 27.7%, while tetralogy of Fallot represented 6.3% of the cases. Other cardiac malformations corresponded to 12.5%. Pulmonary hypertension was associated with 37.5% of the heart diseases. Only 35.5% of the patients were referred before six months of age.CONCLUSIONS: The low percentage of referral until six months of age highlights the need for a better tracking of patients with Down syndrome in the context of congenital heart disease, due to the high frequency and progression of pulmonary hypertension.


2018 ◽  
Vol 27 (1) ◽  
pp. 38-43
Author(s):  
Luh G.A.P. Dewi ◽  
Ni P.V.K. Yantie ◽  
Eka Gunawijaya

Background: Grown-up congenital heart disease (GUCH) patients are unique and challenges especially at developing country. The numbers of diagnostic as well as interventional cardiac catheterization procedures in GUCH patients are growing. The aim of this study was to report the outcome of cardiac catheterization including intervention procedure in GUCH.Methods: The descriptive study was conducted at Sanglah Hospital, Denpasar, Bali, Indonesia. All patients (age of more than 12 years) who underwent cardiac catheterization from 2011 until 2017 were included in this study. Patients, characteristic, types of catheter procedures, immediate complications, and outcomes were documented.Results: A total 54 subjects were included with median age of 23 years and 70% were female. The first symptom that brought patients to hospital is dyspnea 46% and palpitation 32%. Five subjects underwent a diagnostic catheter procedure and 49 (91%) diagnostic and catheter based interventions. Transcatheter interventions procedures included atrial septal defect (ASD) (success rate of 20 per 21), patent ductus arteriosus (PDA) (success rate of 16 per16), ventricular septal defect (VSD) (success rate of  9 per 9), pulmonal stenosis (PS) (success rate of 1 per 2), and aortic stenosis (AS) (success rate of 1 per 1). The complications encountered were transient dysrhythmias in 15 subjects, device embolization in 4 subjects, massive bleeding in 1 subject, and overall mortality in 2 subjects.Conclusion: The number of the catheterization interventions in GUCH was 91% and ASD device closure was the most common procedure. Transcatheter intervention has a high procedural success rates (96%) and low procedural-related complications.


2018 ◽  
Vol 26 (7) ◽  
pp. 756-759 ◽  
Author(s):  
Hua Chun ◽  
Yan Yue ◽  
Yibin Wang ◽  
Zhaxi Dawa ◽  
Pu Zhen ◽  
...  

Background Previous small sample studies suggested that elevated altitudes might be associated with the incidence of cardiovascular diseases. However, it remains uncertain whether high altitudes (over 3000 m above sea level) are related to congenital heart disease. We therefore explored the prevalence of congenital heart disease in a large cohort of students in the world's largest prefecture-level city with the highest altitude. Methods This cross-sectional study included 84,302 student participants (boys 52.12%, girls 47.88%, with an average age of 10.62 ± 3.33 years). Data were extracted from the screening results among different altitude area schools in Nagqu from June 2016 to August 2017. Students were first screened by performing a physical examination consisting of cardiac auscultations and clinical manifestation screenings. An echocardiography was performed to confirm and identify the subtype of congenital heart disease. Results The prevalence of congenital heart disease among students in Nagqu, Tibet, was 5.21‰ (439 cases). The most common congenital heart disease type was patent ductus arteriosus, representing 66.3% of congenital heart diseases diagnosed in this study, followed by atrial septal defect and ventricular septal defect, representing 20.3% and 9.1% of congenital heart diseases, respectively. Students living in higher altitudes were significantly more prone to have congenital heart disease than students in locations with lower altitudes. The prevalence of congenital heart disease in girls was found to be higher than that of boys. Conclusions The correlation between congenital heart disease and increased altitude is noteworthy. This study's results are the first big data epidemiological investigation to confirm that high altitude is a significant environmental risk factor for congenital heart disease, especially patent ductus arteriosus. Furthermore, the results provide additional support to make a diagnostic and treatment plan to prevent congenital heart disease in high altitude areas.


2020 ◽  
Vol 7 (4) ◽  
pp. 39
Author(s):  
Laís Costa Marques ◽  
Gabriel Romero Liguori ◽  
Ana Carolina Amarante Amarante Souza ◽  
Vera Demarchi Aiello

Left ventricular noncompaction (LVNC) is a condition characterized by prominent ventricular trabeculae and deep intertrabecular recesses and has been described as a possible substrate for arrhythmias, thromboembolism, and heart failure. Herein, we explored the prevalence of LVNC morphology among hearts with congenital heart defects (CHD). We examined 259 postnatal hearts with one of the following CHD: isolated ventricular septal defect (VSD); isolated atrial septal defect (ASD); atrioventricular septal defect (AVSD); transposition of the great arteries (TGA); isomerism of the atrial appendages (ISOM); Ebstein’s malformation (EB); Tetralogy of Fallot (TF). Eleven hearts from children who died of non-cardiovascular causes were used as controls. The thickness of the compacted and non-compacted left ventricular myocardial wall was determined and the specimens classified as presenting or not LVNC morphology according to three criteria, as proposed by Chin, Jenni, and Petersen. Normal hearts did not present LVNC, but the CHD group presented different percentages of LVNC in at least one diagnostic criterium. The prevalence of LVNC was respectively, according to Chin’s, Jenni´s and Petersen´s methods: for VSD—54.2%, 35.4%, and 12.5%; ASD—8.3%, 8.3%, and 8.3%; AVSD—2.9%, 2.9%, and 0.0%; TGA—22.6%, 17%, and 5.7%; ISOM—7.1%, 7.1%, and 7.1%; EB—28.6%, 9.5%, and 0.0%; TF—5.9%. 2.9%, and 2.9%. VSD hearts showed a significantly greater risk of presenting LVNC when compared to controls (Chin and Jenni criteria). No other CHD presented similar risk. Current results show some agreement with previous studies, such as LVNC morphology being more prevalent in VSDs. Nonetheless, this is a morphological study and cannot be correlated with symptoms or severity of the CHD.


PEDIATRICS ◽  
1988 ◽  
Vol 82 (4) ◽  
pp. 639-643
Author(s):  
Suguru Matsuoka ◽  
Yoshihide Kurahashi ◽  
Yohko Miki ◽  
Masuhide Miyao ◽  
Yasuhiro Yamazaki ◽  
...  

The plasma level of human α-atrial natriuretic peptide was measured in healthy children and patients, 1 month to 15 years of age, with congenital heart diseases. Significant increases were found in patients with a ventricular septal defect, tricuspid valve atresia, patent ductus arteriosus, and atrial septal defect but not in those with pulmonary valve stenosis or tetralogy of Fallot. The levels were significantly higher in children with ventricular septal defects (221 ± 123 pg/mL) or patent ductus arteriosus (124 ± 38 pg/mL) than in those with atrial septal defects (65 ± 42 pg/mL) (P < .01). The increased levels appeared to be correlated with enlargement of the left atrium (r = .85, P < .01) but not with the right atrial size or the mean right atrial pressure. They were higher in younger than in older healthy infants, but this age difference did not affect the results. These findings indicate that human α-atrial natriuretic peptide is released into the circulation in response to chronic atrial expansion in patients with congenital heart disease and may have an important role in volume homeostasis.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E G Milano ◽  
E Pajaziti ◽  
S Schievano ◽  
A Cook ◽  
C Capelli

Abstract Funding Acknowledgements La Fondation Dassault Systèmes, British Heart Foundation Background Virtual reality (VR) provides a unique possibility to interact with three-dimensional objects. Still in its infancy, the integration of VR with advanced cardiovascular imaging technology allows users to handle patient-specific cardiac models. Purpose The purpose of this study was to evaluate the potential role of VR in teaching cardiac morphology of congenital heart diseases to healthcare professionals. Methods From October 2018 to April 2019, a VR application was developed in-house and incorporated within the Cardiac Morphology courses run monthly at our centre. The VR software included patient-specific 3D models which were reconstructed from 3D imaging datasets (micro-CT, CT, CMR or 3D echo data). The most important cardiac structures were labelled to allow easier identification of anatomical features (Figure 1). Each participant had the possibility to evaluate 6 different patient specific models including: a foetal normal heart, a foetal Transposition of the Great Arteries, a foetal Atrioventricular septal defect, a four-month-old Tetralogy of Fallot, a four-month-old Double Outlet Right Ventricle with uncommitted ventricular septal defect and a one-year-old Patent Ductus Arteriosus. All the attendees could evaluate the models individually for 5 to 15 minutes. A short survey with six questions was administered at the end of the session. The survey included sections asking for professional background information, prior VR experience and feedback on the VR experience which was assessed with a 5 points Likert-type scale (from 1 to 5). Results The VR session was attended by 20 delegates with mixed professional backgrounds including cardiac surgeons, cardiologists, cardiac anaesthesiologists, paediatricians, pathologists and medical students. Only 2 out of 20 had tried a virtual reality application before, although neither of those prior VR experiences had a medical focus. The VR application was considered ‘’extremely helpful’’ (5/5) in understanding the anatomy by 44% of participants, and ‘’very helpful’’(4/5) by another 44%. The methods of interaction (e.g. grabbing objects, using a cutting tool) were considered "extremely intuitive’’ (5/5) by 72% of attendees, and "very intuitive"(4/5) by 27%. In 94% of the cases, the attendees responded to be "very willing"(4/5) or "extremely willing"(5/5) to implement a VR setup at their own institutions for the purpose of evaluating cardiac anatomies. Conclusion The use of the VR station in cardiac morphology courses was very well received by the attendees, as it is frequently considered easy to use and very helpful in aiding the understanding of congenital heart diseases. The survey highlighted a great potential for implementing this tool in educational programmes. Abstract P369 Figure 1


2017 ◽  
Vol 9 (2) ◽  
pp. 97-105
Author(s):  
Nurun Nahar Fatema

Background: Echocardiography is the most sensitive tool to diagnose congenital heart diseases efficiently. It can be repeated as many times as required to see the progress, outcome of treatment and complications. Echocardiography laboratory can give a scenario of pattern of congenital heart diseases existing in Bangladesh as well as natural history of the cases and treatment options offered.Methods: It is a retrospective review of database of echocardiography patient from pediatric noninvasive laboratory of a cardiac hospital from January 2012 to December 2012.Results: Out of 6914 cases 55.73% were male and 44.27% female. Neonates include 8.48%, 36.62% Down Syndrome were infant, 34.02% were under 5 years, 17.97% were children and adolescents and 2.96% were adults. Normal Echocardiography finding was found in 17.28% cases. Ventricular septal defect (VSD) was found in 18.60% cases, Atrial septal defects (ASD) in 15.41% cases, Patent ductus arteriosus (PDA) in 8.59% cases, Atrioventricular septal defect (AVSD) in 1.97% cases, Tetralogy of Fallot (TOF) in 4.79% cases and Transposition of great arteries (TGA) in 2.26% cases. Down syndrome was the commonest chromosomal abnormality seen in 2.4% cases.Conclusion: This study shows that VSD is the commonest congenital heart lesions in our country followed by ASD. Down syndrome was the commonest chromosomal abnormality seen in 2.4% cases.Cardiovasc. j. 2017; 9(2): 97-105


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