Diastolic Dysfunction in Congenital Heart Disease: Clinical Impact and Basic Evaluation

Background and Aim : Echocardiograph is an important diagnostic tool to evaluate cardiac disease and is indispensible for management. So it is important to know the spectrum of cardiac abnormalities that can be detected by echocardiograph and the frequency of these findings may vary depending on where the echocardiogram is performed. Aim of this study was to find out the spectrum of echocardiographic finding in different age group in a medical college hospital. Methods and materials : A retrospective observational study was done to at Dhulikhel Hospital to review Echocardiographic profile of 3310 patients who were indicated for echocardiogram over a period of 3 years. Data collected from echocardiograph report registry. Data analysis was done using SPSS 17. Result : Congenital Heart Disease(CHD) (37.74%),Normal finding( 21.19%), Pericardial Heart Disease(19.21%) and Rheumatic Heart Disease(RHD)(17.88%) were the echocardiographic finding in children. In adolescents and young adults Rheumatic Heart Disease (49.90%), Hypertensive Heart Disease (13.34%), Congenital Heart Disease (6.58%), and Pericardial Disease (4.38%) were found. Most common finding in middle age was cor-pulmonale (34.76%) followed by Diastolic Dysfunction (20.60%), Hypertensive Heart Disease(17.06%),Ischemic Heart Disease(IHD) (12.80%). In elderly age most common finding was Diastolic Dysfunction (57.14%). Conclusion : The spectrum of echocardiograph finding in a medical college hospital ranges from Congenital Heart Disease, Rheumatic Heart Disease, Ischemic Heart Disease ,Pericardial disease, Corpulmonale, Diastolic Dysfunction, systolic dysfunction and degenerative valve disease. Streptococcal sore throat leading to Rheumatic Heart Disease and complication of tuberculosis and parasitic infestation leading to pericardial diseases, as well as Hypertensive Heart Disease, and Ischemic Heart Disease constitutes burden in Nepal. Cor-pulmonale and ) Sanjaya Humagain, Ramsundar Twayana, Rajendra Koju. DOI: http://dx.doi.org/10.3126/njh.v11i1.10976 Nepalese Heart Journal 2014;11(1): 13-17

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Clinical impact of left ventricular eccentricity index using cardiac MRI in assessment of right ventricular hemodynamics and myocardial fibrosis in congenital heart disease

European Radiology ◽

10.1007/s00330-015-4199-9 ◽

2016 ◽

Vol 26 (10) ◽

pp. 3617-3625 ◽

Cited By ~ 7

Author(s):

Yuzo Yamasaki ◽

Michinobu Nagao ◽

Takeshi Kamitani ◽

Torahiko Yamanouchi ◽

Satoshi Kawanami ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Right Ventricular ◽

Myocardial Fibrosis ◽

Cardiac Mri ◽

Congenital Heart ◽

Left Ventricular ◽

Clinical Impact ◽

Eccentricity Index

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Clinical impact of cardiac computed tomography derived three-dimensional strain for adult congenital heart disease: a pilot study

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-019-01691-w ◽

2019 ◽

Vol 36 (1) ◽

pp. 131-140 ◽

Cited By ~ 4

Author(s):

Yumi Shiina ◽

Kei Inai ◽

Tatsunori Takahashi ◽

Yamato Shimomiya ◽

Michinobu Nagao

Keyword(s):

Computed Tomography ◽

Congenital Heart Disease ◽

Heart Disease ◽

Pilot Study ◽

Congenital Heart ◽

Cardiac Computed Tomography ◽

Adult Congenital Heart Disease ◽

Three Dimensional ◽

Clinical Impact ◽

Adult Congenital

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664. Clinical Impact of Cell-Free DNA Metagenomics in Diagnosing Infectious Diseases in Pediatrics: A Single-Center Experience

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.861 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S434-S434

Author(s):

William Otto ◽

Rebekah Dumm ◽

Yasaman Fatemi ◽

Sanjeev K Swami

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Plasma Cell ◽

Clinical Condition ◽

Congenital Heart ◽

Clinical Care ◽

Clinical Impact ◽

Cell Free Dna ◽

Free Dna ◽

The Ideal

Abstract Background Metagenomic next-generation sequencing (mNGS) of plasma cell-free DNA has significant potential to improve infectious diseases diagnostics through unbiased detection of pathogens. However, the optimal patient population or clinical condition for this testing has not been determined. Methods We performed a retrospective review of all orders for plasma cell-free DNA mNGS using the Karius test (Karius, Redwood City, CA) from The Children’s Hospital of Philadelphia from 7/1/19-4/30/21. Chart review then determined if the test had a positive, negative, or no clinical impact. Results 25 mNGS tests were ordered on 24 unique patients. The majority of tests were ordered on immunocompromised patients (Table 1). Most mNGS tests were ordered after completion of routine microbiological testing (17/25, 71%). Three tests were not completed as ordered. Most completed tests (18/22, 82%) had no impact on clinical care as they confirmed the known diagnosis or were not acted upon (Figure 1). mNGS testing had a positive impact in 2 cases. For one patient with congenital heart disease presented with persistent fever and concern for endocarditis despite negative infectious workup, a negative mNGS result allowed for continued monitoring without therapy. Another patient with a lymphatics disorder had mNGS performed due to persistent clinical instability; testing was positive for Candida parapsilosis, allowing for early initiation of antifungal therapy. However, test results had a negative clinical impact in 2 other patients. In a patient with congenital heart disease and fever, identification of two organisms led to prolonged antibiotic therapy for endocarditis without resolution of symptoms. In a patient with leukemia, report of a dematiaceous mold led to further diagnostic testing, including a lumbar puncture, as well as treatment with antifungal therapy despite no clear diagnosis. Table 1 Conclusion In this study, the majority of plasma cell-free mNGS tests had no impact on clinical care. mNGS testing did positively impact care in 2 patients, but did had a negative impact on care in 2 instances, leading to further testing and unnecessary treatment. Further investigation is needed to determine the ideal population or clinical condition for testing and the ideal time of sending plasma cell-free mNGS tests. Disclosures All Authors: No reported disclosures

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