scholarly journals Critical Congenital Heart Diseases as Life-threatening Conditions in the Emergency Room

2016 ◽  
Vol 2 (1) ◽  
pp. 7-10 ◽  
Author(s):  
Rodica Togănel
Keyword(s):  
Congenital Heart Disease ◽  
Congenital Heart ◽  
Clinical Presentation ◽  
Heart Diseases ◽  
Ductus Arteriosus ◽  
Congenital Heart Diseases ◽  
Critical Congenital Heart Disease ◽  
Urgent Surgery ◽  
Life Threatening ◽  
Patent Ductus

Abstract Critical congenital heart disease (CHD) represents a special type of cardiovascular emergency due to the complexity of the associated pathology. In many cases, urgent surgery or catheter-based intervention is required as the condition might be life-threatening. In patients with ductal-dependent lesions, closure of the patent ductus arteriosus (PDA) within the first few days postpartum, can cause sudden clinical deterioration with potentially life-threatening consequences. The diagnostic challenges, clinical presentation and particularities related to the closure of PDA in life-threatening critical CHD are presented.

scholarly journals High prevalence of congenital heart disease at high altitudes in Tibet

2018 ◽  
Vol 26 (7) ◽  
pp. 756-759 ◽  
Author(s):  
Hua Chun ◽  
Yan Yue ◽  
Yibin Wang ◽  
Zhaxi Dawa ◽  
Pu Zhen ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Patent Ductus Arteriosus ◽  
High Altitude ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Diseases ◽  
Ductus Arteriosus ◽  
Congenital Heart Diseases ◽  
Patent Ductus

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.

scholarly journals Complex Congenital Heart Disease in an Infant - A Case Report and Review

2021 ◽  
Vol 10 (39) ◽  
pp. 3505-3507
Author(s):  
Srinivas Naik ◽  
Sourya Acharya ◽  
Gajendra Agrawal ◽  
Chetan Rathi ◽  
Sunil Kumar
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Early Diagnosis ◽  
Congenital Heart ◽  
Clinical Presentation ◽  
Heart Diseases ◽  
Diagnosis And Treatment ◽  
Ductus Venosus ◽  
Congenital Heart Diseases ◽  
Life Threatening

Congenital heart disease (CHD) often poses a great diagnostic challenge for physicians. Despite antenatal diagnostic tests advancing to a great level, accurate diagnosis and treatment of congenital heart diseases is mandatory. These diseases range from mild to severe life-threatening scenarios sometimes having vague presentations making diagnosis even more difficult. Early diagnosis and treatment are usually lifesaving.1 Congenital heart diseases can often be classified as cyanotic and acyanotic based on clinical presentation. After birth, fetal structures like foramen ovale, ductus venosus and ductus arteriosus are no longer required for survival and they begin to close.2 Persistence of such structures after birth is a sign of congenital heart diseases. High mortality contributing diseases which require prompt intervention include hypoplastic left heart syndrome (HLHS), coarctation of aorta (COA), interrupted aortic arch (IAA), transposition of the great arteries (TGA), total anomalous pulmonary venous return (TAPVR), critical aortic stenosis (AS) pulmonary atresia (PA) and tricuspid atresia (TA).3 They contribute to significant mortality amongst neonatal age groups. Recognition of congenital heart diseases based on clinical fractures like cyanosis, tachycardia, tachypnoea, irritability, refusal to feed stabilisation and prompt referral to tertiary cardiac centre are critical to improve outcomes in neonates with CHDs, seizures, murmur etc is diagnostically challenging but lifesaving. Life-threatening CHDs may perhaps present with cyanosis, respiratory distress, shock or collapse; all of these are also frequent clinical presentation of various respiratory problems or sepsis in newborn. Early diagnosis and prompt treatment are the only life saving measures.

A retrospective analysis of a pediatric tele-echocardiography service to treat, triage, and reduce trans-Pacific transport

2017 ◽  
Vol 24 (3) ◽  
pp. 224-229 ◽  
Author(s):  
Christopher A Rouse ◽  
Brandon T Woods ◽  
C Becket Mahnke
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
The United States ◽  
Critical Congenital Heart Disease ◽  
Medical Centers ◽  
Prompt Diagnosis ◽  
Patent Ductus

Introduction Tele-echocardiography can ensure prompt diagnosis and prevent the unnecessary transport of infants without critical congenital heart disease, particularly at isolated locations lacking access to tertiary care medical centers. Methods We retrospectively reviewed all infants who underwent tele-echocardiography at a remote 16-bed level IIIB NICU from June 2005 to March 2014. Tele-echocardiograms were completed by cardiac sonographers in Okinawa, Japan, and transmitted asynchronously for review by pediatric cardiologists in Hawaii. Results During the study period 100 infants received 192 tele-echocardiograms: 46% of infants had tele-echocardiograms completed for suspected patent ductus arteriosus, 28% for suspected congenital heart disease, 12% for possible congenital heart disease in the setting of likely pulmonary hypertension, and 10% for possible congenital heart disease in the setting of other congenital anomalies. Of these, 17 patients were aeromedically evacuated for cardiac reasons; 12 patients were transported to Hawaii, while five patients with complex heart disease were transported directly to the United States mainland for interventional cardiac capabilities not available in Hawaii. Discussion This study demonstrates the use of tele-echocardiography to guide treatment, reduce long and potentially risky trans-Pacific transports, and triage transports to destination centers with the most appropriate cardiac capabilities.

scholarly journals Study the universal critical congenital heart disease screening in a peripheral area of Uttarakhand, India

2020 ◽  
Vol 7 (9) ◽  
pp. 1849
Author(s):  
Ravi Sahota ◽  
Navpreet Kaur ◽  
Gurpal Singh ◽  
Veena Joshi ◽  
Bharti Gahtori ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Screening Program ◽  
Heart Diseases ◽  
Research Work ◽  
Congenital Heart Diseases ◽  
Critical Congenital Heart Disease ◽  
Cross Sectional ◽  
Birth Prevalence

Background: Congenital heart disease (CHD) is the most frequently occurring congenital disorder, responsible for 28% of all congenital birth defects. The birth prevalence of CHD is reported to be 8-12/1000 live births. Considering a rate of 9/1000, about 1.35 million babies are born with CHD each year globally. Objective of research work to study the prevalence of CHD among newborn and its types.Methods: This cross-sectional study was carried among 34 cases of CHD/5126 newborn screened at 4 birthing places in Kashipur a small town in Uttrakhand at pediatrics department of Sahota Super-specialty hospital, Kashipur, Uttarakhand. Screening program between 22 August 2014, and March 30, 2019. All newborns, including preterm babies, delivered in these facilities were eligible for inclusion in this study.Results: Present study found the prevalence of CHD was 0.7 per 1000 children (34/5126). Around 26.5% participants have cyanotic CHD and 73.5% have acynotic CHD. Almost 44%, 28%, 20%, 4% and 4% participants of acynotic congenital heart diseases have VSD, ASD, PDA, AVSD and valvular PS respectively and 55.6%, 22.2%, 11.1% and 11.1% participants of cynotic congenital heart diseases have TOF, DORV/VSD, dTGA/VSD and tricuspid atresia respectively.Conclusions: Screening for congenital heart disease should be included as a part of newborn assessment as it is a common congenital problem. Early identification influences outcome. Barriers in implementation of the screening programmes in resource limited setting is a challenging feature. This study can provide observed data that can help in policy making in the health sector.

scholarly journals Transcatheter closure of tubular type patent ductus arteriosus using Amplatzer® ductal occluder II: a case report

2016 ◽  
Vol 53 (5) ◽  
pp. 291
Author(s):  
Mulyadi M Djer ◽  
Nikmah Salamia Idris ◽  
Angelina Angelina
Keyword(s):  
Patent Ductus Arteriosus ◽  
Congenital Heart ◽  
Transcatheter Closure ◽  
Heart Diseases ◽  
Ductus Arteriosus ◽  
Preterm Neonates ◽  
Congenital Heart Diseases ◽  
Residual Shunt ◽  
Tubular Type ◽  
Patent Ductus

Patent ductus arteriosus (PDA) is a common congenital heart disease, accounting for 5-10% of all congenital heart diseases. The incidence of PDA is even higher in preterm neonates, ranging from 20-60%.1-4 Closure of PDA is indicated in all cases, except for duct-dependent congenital heart diseases or PDA with Eisenmenger syndrome.1,5,6 In small asymptomatic PDAs, closure is indicated to prevent the risk of complications, such as endarteritis, endocarditis, aneurysm of ductus arteriosus, or congestive heart failure.1,2,7In recent years, interventional cardiology has become a gold standard therapy for the majority of PDA cases beyond neonatal age. Since its introduction in 1967, many devices and methods have been developed to allow transcatheter closure of virtually all PDAs, regardless of size or configuration. Nevertheless, the tubular shape (type C) PDA, which has the highest residual shunt rate, still poses a great challenge for the interventionist.8-10 The second generation of Amplatzer® device occluders (ADO II), released in 2007, has been suggested to be effective in closing tubular PDAs.10 The purpose of this study was to report the initial clinical experience using ADO II to close a tubular type PDA in Indonesia.

scholarly journals Recent Advancement in Non-surgical Interventional Treatment in Congenital Heart Disease at National Institute of Cardiovascular Disease (NICVD)-a Tertiary Care Hospital of Bangladesh

2014 ◽  
Vol 6 (2) ◽  
pp. 133-142
Author(s):  
ABMA Salam ◽  
AMA Kamali ◽  
KA Hasan ◽  
H Ataul ◽  
M Selim ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
Interventional Treatment ◽  
Congenital Heart Diseases ◽  
Care Hospital ◽  
Device Closure

Background: Treatment of Congenital Heart Disease (CHD) is either Surgical or Interventional. Medical management is mainly symptomatic / palliative. Although surgery is the main mode of treatment but in the recent past non-surgical Interventional method is replacing it because of its multiple advantages over surgical procedures. Since 2005, we started our journey in National Institute of Cardiovascular Diseases with a PDA device closure. In this article we tried to review the success rate of the interventional procedures in this hospital. Methods: The aim of this retrospective study is to review the short term & Intermediate outcome of the non surgical interventional treatment of congenital heart diseases. We included all the interventional rocedures done in this Institute since 2005 upto December 2013. Results: During this period, we performed total 150 cases of patent ductus arteriosus (PDA) device, 20 cases of PDA Coil closure, 60 cases of atrial septal defect (ASD) device, 90 cases of Balloon Pulmonary Valvuloplasty (BPV), 20 cases of Balloon Aortic Valvuloplasty (BAV), 22 cases of Coarctation Balloon Angioplasty, 35 cases of Mitral Valvuloplasty (PTMC), 15 cases of Balloon Atrial Septostomy. Almost all of our intervention procedures were successful except one case of mortality related to procedure of PDA device closure, 4 device embolization (2 ASD & 2 PDA) and one case of PDA coil with persistent Intravascular hemolysis. All the embolized devices were subsequently retrieved surgically with repair. All other patients of interventional treatment are enjoying new life without any morbidity. Conclusion: Thus, we concluded that interventional methods of suitably selected case of congenital heart disease may be an alternative lucrative safe & effective option of remedy for many of the congenital heart diseases. DOI: http://dx.doi.org/10.3329/cardio.v6i2.18354 Cardiovasc. j. 2014; 6(2): 133-142

scholarly journals Congenital Heart Disease Requiring Maintenance of Ductus Arteriosus in Critically Ill Newborns Admitted at A Tertiary Neonatal Intensive Care Unit

2016 ◽  
Vol 2 (4) ◽  
pp. 185-191 ◽  
Author(s):  
Manuela Cucerea ◽  
Marta Simon ◽  
Elena Moldovan ◽  
Marcela Ungureanu ◽  
Raluca Marian ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Side Effects ◽  
Pulmonary Circulation ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Ductus Arteriosus ◽  
Prostaglandin E ◽  
Critical Congenital Heart Disease ◽  
The Mean

AbstractIntroduction: Congenital heart diseases (CHD) have been reported to be responsible for 30 to 50% of infant mortality caused by congenital disabilities. In critical cases, survival of newborns with CHD depends on the patency of the ductus arteriosus (PDA), for maintaining the systemic or pulmonary circulation. The aim of the study was to assess the efficacy and side effects of PGE (prostaglandin E) administration in newborns with critical congenital heart disease requiring maintenance of the ductus arteriosus.Material and method: All clinical and paraclinical data of 66 infants admitted to one referral tertiary level academic center and treated with Alprostadil were analyzed. Patients were divided into three groups: Group 1: PDA dependent pulmonary circulation (n=11) Group 2: PDA dependent systemic circulation (n=31) Group 3: PDA depending mixed circulation (n=24)Results: The mean age of starting PGE1 treatment was 2.06 days, 1.91 (+/−1.44) days for PDA depending pulmonary flow, 2.39 (+/−1.62) days for PDA depending systemic flow and 1.71 (+/1.12) for PDA depending mixing circulation. PEG1 initiation was commenced 48 hours after admission for 72%, between 48-72 hours for 6%, and after 72 to 120 hours for 21% of newborns detected with PDA dependent circulation. Before PEG1 initiation the mean initial SpO2 was 77.89 (+/− 9.2)% and mean initial oxygen pressure (PaO2) was 26.96(+/−6.45) mmHg. At the point when stable wide open PDA was achieved their mean SpO2increased to 89.73 (+/−8.4)%, and PaO2 rose to 49 (+/−7.2) mmHg. During PGE1 treatment, eleven infants (16.7%) had apnea attacks, five children (7.5%) had convulsions, 33 (50%) had fever, 47 (71.2%) had leukocytosis, 52 (78.8%) had edema, 25.8% had gastrointestinal intolerance, 45.5% had hypokalemia, and 63.6% had irritability.Conclusions: For those infants with severe cyanosis or shock caused by PDA dependent heart lesions, the initiation and maintenance of PGE1 infusion is imperative. The side effects of this beneficial therapy were transient and treatable.

Use of prostaglandins in duct-dependent congenital heart conditions

2017 ◽  
Vol 103 (3) ◽  
pp. 137-140 ◽  
Author(s):  
Yogen Singh ◽  
Paraskevi Mikrou
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Infant Mortality ◽  
Patent Ductus Arteriosus ◽  
Congenital Heart ◽  
Prostaglandin E1 ◽  
Clinical Presentation ◽  
Ductus Arteriosus ◽  
Fetal Period ◽  
Patent Ductus

Congenital heart disease (CHD) remains a leading cause of infant mortality, which is even higher in infants with undiagnosed duct-dependent CHDs. Up to 39%–50% of infants with critical CHD are being discharged undiagnosed from the hospital. Infants with duct-dependent critical CHD remain well during the fetal period and may deteriorate when the ductus arteriosus (commonly called ‘duct’) closes after birth. It is critical to open or maintain ductus arteriosus patent in infants with duct-dependent CHDs. Prostaglandin E1 (alprostadil marketed as ‘Prostin VR ’) and prostaglandin E2 (dinoprostone) are used to maintain a patent ductus arteriosus and the dose of medication depends on the clinical presentation. Delay in starting prostaglandin infusion can have deleterious effects on infants and can even lead to death. These infants often present as an emergency, and professionals caring for these infants need to have a good understanding of these conditions and medications used for ductal patency.

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