Dental Management of the Down and Eisenmenger Syndrome Patient

2004 ◽  
Vol 5 (2) ◽  
pp. 70-80 ◽  
Author(s):  
Evelyn M. Chung ◽  
Eric C. Sung ◽  
Kari L. Sakurai
Keyword(s):  
Congenital Heart ◽  
Septal Defect ◽  
Heart Defects ◽  
Ductus Arteriosus ◽  
Medical Complications ◽  
Eisenmenger Syndrome ◽  
Syndrome Patient ◽  
Septal Defects ◽  
Dental Management ◽  
Work Up

Abstract About 40% to 50% of Down syndrome (DS) patients can have significant congenital heart defects such as patent ductus arteriosus, Tetralogy of Fallot, and septal defects. Patients with large septal defects may develop Eisenmenger syndrome (ES), which is defined by the cardiac septal defect and pulmonary hypertension coupled with a reverse right to left shunting of blood flow. DS patients that suffer from this condition require special considerations in the delivery of their dental care to prevent further medical complications or emergencies such as infection, cyanotic episodes, and thromboemboli. Collaboration with the cardiologist is also essential to ensure a complete and comprehensive pre-operative work up. The purpose of this article is to describe the dental management of DS patients with ES under general anesthesia. Citation Chung EM, Sung EC, Sakurai KL. Dental Management of the Down and Eisenmenger Syndrome Patient. J Contemp Dent Pract 2004 May;(5)2:070-080.

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
Keyword(s):  
Congenital Heart ◽  
Septal Defect ◽  
Heart Diseases ◽  
Heart Defects ◽  
Acute Myocarditis ◽  
Ductus Arteriosus ◽  
Myocardial Damage ◽  
Left Ventricular ◽  
Healthcare Facilities ◽  
Lv Dysfunction

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.

scholarly journals Challenges in the Patient With Pulmonary Hypertension and Atrial Septal Defect: Understanding When and How to Close the Defect

2019 ◽  
Vol 18 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Mary P. Mullen
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Arterial Hypertension ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Defects ◽  
Defect Closure ◽  
Long Term Outcomes ◽  
Septal Defects ◽  
Pulmonary Arterial

Atrial septal defects (ASDs) are common congenital heart defects in children and adults. Pulmonary arterial hypertension (PAH) is found in subsets of both pediatric and adult patients with atrial defects under varied clinical contexts. The pulmonary hypertension specialist is often faced with questions surrounding timing and method of defect closure, which may have significant impact on procedural and long-term morbidity and survival. This review highlights important differences in management between children and adults with ASDs associated with PAH, highlighting indications for closure, operability, types of closure, and long-term outcomes.

scholarly journals P1465 Ventricular septal defect and pulmonary artery aneurysm; How does it look by three dimensional echocardiography

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
H S A Abdelgawad ◽  
M Abdelnabi ◽  
A Almaghrabi ◽  
M Shehata ◽  
M A Abdelhay
Keyword(s):  
Shear Stress ◽  
Pulmonary Artery ◽  
Congenital Heart ◽  
Pulmonary Valve ◽  
Heart Defects ◽  
Ductus Arteriosus ◽  
Maximum Diameter ◽  
Surgical Closure ◽  
Septal Defects ◽  
Aneurysm Formation

Abstract Introduction Pulmonary artery (PA) aneurysms (PAAs) are rare and infrequently diagnosed . The upper limit of the main PA diameter (29 mm) was defined as a PAA. Congenital causes have been recognized as the major reason for PAA formation. More than 50% of all cases were associated with congenital heart disease. The 3 most frequent congenital heart defects associated with a PAA are, in decreasing order, persistent ductus arteriosus (PDA), ventricular septal defects (VSD) , and atrial septal defects (ASD).En face visualization of the whole circumference of the VSD and its relation to the surrounding structures can help in better understanding of the shear stress that promote PAA formation. Case report A 35 year old female patient with no previous cardiac history .She presented to our medical facility complaining of exertional dyspnea since 2 years . On clinical examination, she had harsh pansystolic murmur heard over left parasternal area . 2D Transthoracic Echocardiography revealed an aneurysmally dilated pulmonary artery (40mm in maximum diameter) and a wide VSD. 3D transthoracic and transesophageal echocardiography showed a wide subarterial VSD which is immediately located below the pulmonary valve. Therefore , that increased flow caused by left-to-right shunt caused by the intimate location of the VSD to the pulmonary valve results in increased hemodynamic shear stress on the vessel walls and therefore promotes aneurysm formation .Surgical closure of the VSD was done successfully with no residual defects. Conclusion PAAs seldom occur, are rarely diagnosed, and do not present with distinct symptoms. With the help of 3D echocardiography , direct visualization of the surrounding septal defects helps better understanding of mechanism of the aneurysm formation. Abstract P1465 Figure.

Plasma Atrial Natriuretic Peptide in Patients With Congenital Heart Diseases

PEDIATRICS ◽  
1988 ◽  
Vol 82 (4) ◽  
pp. 639-643
Author(s):  
Suguru Matsuoka ◽  
Yoshihide Kurahashi ◽  
Yohko Miki ◽  
Masuhide Miyao ◽  
Yasuhiro Yamazaki ◽  
...  
Keyword(s):  
Atrial Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Diseases ◽  
Ductus Arteriosus ◽  
Right Atrial ◽  
Congenital Heart Diseases ◽  
Septal Defects ◽  
Atrial Natriuretic

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.

scholarly journals Cardiac Septal Defects in Children: Hemodynamics, Clinical Manifestations and Detection

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Ria Nova ◽  
Sukman Tulus Putra ◽  
Siti Nurmaini ◽  
Radiyati Umi Partan
Keyword(s):  
Clinical Examination ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Defects ◽  
Clinical Manifestations ◽  
Ventricular Septal Defects ◽  
Hemodynamic Changes ◽  
Septal Defects ◽  
Cardiac Septal Defects ◽  
The Right

Cardiac septal defect in children is one of the congenital heart defects characterized by atrial septal defects (ASD), ventricular septal defects (VSD) and defects in both atrial and ventricular septum (AVSD). The hemodynamic changes that occur are caused by a left to the right shunt. Differences in location, size of the defect and pulmonary vascular resistance make hemodynamic differences and clinical manifestations between the three types of cardiac septal defects. Detection of cardiac septal defects can be done by clinical examination by listening to the characteristic heart sounds and murmurs for each defect. However, clinical examination alone is often still difficult to determine the type of cardiac septal defect so that several supporting examinations such as photothorax, ECG, echocardiogram and cardiac catheterization need to be done to help establish the diagnosis.

scholarly journals Cardiac Septal Defects in Children: Hemodynamics, Clinical Manifestations and Detection

2021 ◽  
Vol 5 (6) ◽  
pp. 608-613
Author(s):  
Ria Nova ◽  
Sukman Tulus Putra ◽  
Siti Nurmaini ◽  
Radiyati Umi Partan
Keyword(s):  
Clinical Examination ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Defects ◽  
Clinical Manifestations ◽  
Ventricular Septal Defects ◽  
Hemodynamic Changes ◽  
Septal Defects ◽  
Cardiac Septal Defects ◽  
The Right

Cardiac septal defect in children is one of the congenital heart defects characterized by atrial septal defects (ASD), ventricular septal defects (VSD) and defects in both atrial and ventricular septum (AVSD). The hemodynamic changes that occur are caused by a left to the right shunt. Differences in location, size of the defect and pulmonary vascular resistance make hemodynamic differences and clinical manifestations between the three types of cardiac septal defects. Detection of cardiac septal defects can be done by clinical examination by listening to the characteristic heart sounds and murmurs for each defect. However, clinical examination alone is often still difficult to determine the type of cardiac septal defect so that several supporting examinations such as photothorax, ECG, echocardiogram and cardiac catheterization need to be done to help establish the diagnosis.

scholarly journals Spectrum of pediatric heart disease in newly established cardiac center in South Punjab.

2020 ◽  
Vol 27 (11) ◽  
Author(s):  
Ahsan Beg ◽  
Nousheen Fatima ◽  
Abdul Razzaq Mughal
Keyword(s):  
Heart Disease ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Diseases ◽  
Heart Defects ◽  
Ductus Arteriosus ◽  
Female Ratio ◽  
Acquired Heart Disease ◽  
Pediatric Heart Disease ◽  
Cardiac Center

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.

scholarly journals DOWN’S SYNDROME;

2013 ◽  
Vol 20 (06) ◽  
pp. 898-903
Author(s):  
SHAKIL AHMAD ◽  
IMRAN SARWAR ◽  
NISAR KHAN SAJID
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Maternal Age ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Defects ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Septal Defects ◽  
Age At Birth

Objective: To evaluate the various types of congenital heart defects and to determine their frequency in children withDown’s syndrome. Study Design: Descriptive study. Place and duration of study: Department of Pediatrics, Independent UniversityHospital Faisal Abad Pakistan, from January 2010 to December 2012. Methodology: 93 children between the ages of day 1 to 12 years,diagnosed clinically as Down’s syndrome based on its characteristic phenotypic appearance, were included in the study. A detailedhistory, physical examination and evaluation of cardiovascular status (including Chest x-ray, Electrocardiogram and Echocardiography)were performed in each Down’s syndrome case. Variables of interest included age, sex, maternal age at birth and type and frequency ofcongenital heart disease. Results: Congenital heart disease was present in 48 (51.62%) children out of 93 children with Down’ssyndrome. Congenital cardiac defects in order of predominant type and their frequency included Ventricular septal defect (29, 60.4%),Atrioventricular septal defect (14, 29.1%), Atrial septal defect (2, 4.1%), Patent ductus arteriosis (2, 4.1%) and Tetralogy of Fallots (1,2%). 68 (73.2%) Down’s syndrome children (n=93) presented during their first year of life with mean age of 7±4 months. Malepredominance was observed in both with and without congenital heart disease Down’s syndrome children (male: female 1.7:1 and 2.5:1respectively). Mean maternal age at birth was 27±2 years. Conclusions: Congenital heart disease (CHD) is frequently associated withDown’s syndrome (DS). Ventricular septal defects and atrioventricular septal defects are the most common forms of CHDs in DS childrenof our region. Their earlier presentation (in infancy) and significant contribution to the morbidity and mortality of DS children warrantsearly diagnosis of DS and mandatory screening of all DS children for associated CHDs.

scholarly journals Pattern of un-operated Grown Up Congenital Heart (GUCH) patients presenting to a Tertiary Care Cardiac Institute of Punjab

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Abdul Razzaq Mughal ◽  
Rubina Tousif ◽  
Asif Rashid Alamgir ◽  
Anjum Jalal
Keyword(s):  
Pulmonary Hypertension ◽  
Infective Endocarditis ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Defects ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
Signs And Symptoms ◽  
Systemic Hypertension ◽  
Morbid Conditions

Objectives: To identify the pattern of un-operated grown up congenital heart defects at our tertiary care cardiac institute. Methods: This is a prospective observational study. All un-operated GUCH patients who presented to Faisalabad Institute of Cardiology (FIC) from May 2017 to 30th July 2017 were enrolled. Diagnosis was established on Transthoracic Echocardiography done by dedicated pediatric cardiologist at FIC. The mode of presentation, presenting complaints, type, severity, complications and co-morbid conditions of CHD were recorded. Results: A total of 200 consecutive patients were enrolled. Mean age was 29.92 ± 11.21 years. There were 104 females (52%) and 96 males (48%). Majority of patients presented in Out-Patient Department (84%) while 16% presented in emergency (n=32). The most common cardiac anomalies were: Atrial Septal Defect (ASD) 41.5% (83), Tetralogy of Fallots (TOF) 42 (21%), Ventricular Septal Defect (VSD) 28 (14%) and Patent ductus arteriosus (PDA) 8 % (16). Cyanotic CHD was present in 43% (86) while TOF was the most common of it. The disease was of moderate complexity in 77.5% patients. Certain complications like Pulmonary hypertension 69(34.5%), Eisenmenger 33(16.5%), Rhythm disturbances 15 (7.5%), Infective endocarditis 5(2.5%) were also present along with co-morbid conditions like coronary artery disease (1.5% and systemic hypertension (2.5%). Dyspnea on exertion (59.5%) followed by cyanosis (41%) were the most common presenting complaints. The most common reason for hospital admission was cardiac signs and symptoms (19.5%) followed by cardiac catheterization (10.5%). Conclusion: The ASD, TOF, VSD and PDA remain the most common CHD in descending order while pulmonary hypertension, Eisenmenger, heart failure, arrhythmias, infective endocarditis and stroke were the common complications of CHD at this particular age. doi: https://doi.org/10.12669/pjms.35.4.878 How to cite this:Mughal AR, Tousif R, Alamgir AR, Jalal A. Pattern of un-operated Grown Up Congenital Heart (GUCH) patients presenting to a Tertiary Care Cardiac Institute of Punjab. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.878 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Congenital heart defects in dogs: A retrospective study of 301 dogs

2017 ◽  
Vol 73 (10) ◽  
pp. 651-656
Author(s):  
Magdalena Garncarz ◽  
Marta Parzeniecka-Jaworska ◽  
Olga Szaluś-Jordanow
Keyword(s):  
Retrospective Study ◽  
Congenital Heart Defects ◽  
Medical Records ◽  
Congenital Heart ◽  
Septal Defect ◽  
Early Recognition ◽  
Heart Defects ◽  
Ductus Arteriosus ◽  
Subaortic Stenosis ◽  
Patent Ductus

The aim of the study was to assess the frequency of congenital heart defects in a population of dogs in Poland and to determine which breeds were affected by particular defects. A retrospective study of the medical records of cardiologically examined dogs revealed 301 cases of echocardiographically confirmed congenital heart defects. Dogs with congenital heart defects made up 2.7% of the dogs that underwent a cardiologic examination. The age at diagnosis ranged from 2 weeks to 190 months. Mixed breeds (33 dogs, 11%), Bull Terriers (31, 10%), Boxers (28, 9%), German Shepherds (17, 6%), Yorkshire Terriers (17, 6%), and French Bulldogs (16, 5%) were the most frequently affected breeds. Subaortic stenosis (120 cases, 33.9%), pulmonic stenosis (64, 18.1%), patent ductus arteriosus (59, 16.7%), mitral valve dysplasia (56, 15.8%), ventricular septal defect (24, 6.8%) and tricuspid valve dysplasia (17, 4.8%) were the most frequent congenital heart defects recognized in this study. Isolated congenital heart disease occurred in 258 dogs (86%), while multiple heart defects were noted in 43 dogs (14%). Most (60%) congenital heart defects were recognized in dogs older than 1 year. Early recognition of congenital heart defects is important for better patient care. Collecting information on the frequency of congenital heart defects in particular breeds will be useful in educating breeders and thus in improving the overall health of the breed.

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