Nonimmune hydrops fetalis management from the perspective of fetal cardiologists: A single tertiary center experience from Egypt

2020 ◽  
pp. 1-8
Author(s):  
S. Rakha ◽  
H. Elmarsafawy
Keyword(s):  
Perinatal Mortality ◽  
Heart Diseases ◽  
Fetal Echocardiography ◽  
Hydrops Fetalis ◽  
Tertiary Center ◽  
Structural Heart Diseases ◽  
Profile Score ◽  
Antenatal Management ◽  
Fetal Tachyarrhythmia ◽  
Nonimmune Hydrops

BACKGROUND: Despite advances in managing nonimmune hydrops fetalis (NIHF), perinatal mortality is still significant. Fetal cardiac failure eventually occurs regardless of etiology. However, no previous study has addressed NIHF from fetal cardiologists’ perspective. Therefore, we evaluated etiology and management of a NIHF cohort requiring fetal cardiologist consultation in a developing country. METHODS: A single-center retrospective cohort study of 70 cases with NIHF that were referred to a fetal cardiology unit over four years was performed. Demographics, etiologic diagnosis, and outcomes of the cases were assessed. Antenatal management was evaluated using cardiovascular profile score (CVPS). RESULTS: The most frequent diagnosis was Idiopathic hydrops 42(62.6%), followed by hydrops due to cardiac diseases 19(28.4%), and 3 dead fetuses were detected at the first fetal echocardiography. Treatment of fetal tachyarrhythmia (n = 7) had 100% success rate in terms of antenatal hydrops resolution. Digoxin was used in cases of structural heart diseases, twin- twin transfusion syndrome, and dilated cardiomyopathy with perinatal mortality occurring in all cases (n = 9). In cases of idiopathic hydrops, 14 fetuses received digoxin with intrauterine hydrops resolution in 2/14 (14%) while non-treated cases had intrauterine or early neonatal death. CONCLUSION: Nonimmune hydrops is the worst complication of diverse etiologies. Limitations in resources for advanced investigations in developing countries increase the possibility of categorizing NIHF as idiopathic. Tachyarrhythmia induced hydrops can be entirely reversed with antenatal therapy while non-tachyarrhythmia fetal cardiac disease outcomes are unfavorable regardless of therapy. On the other hand, idiopathic hydrops shows a limited potential response to digoxin in utero.

The many etiologies of nonimmune hydrops fetalis diagnosed by exome sequencingThe monogenic background of hydrops fetalis.

2021 ◽  
Author(s):  
Tova Wagner ◽  
Duha Fahham ◽  
Frumkin Ayala ◽  
Avraham Shaag ◽  
Simcha Yagel ◽  
...  
Keyword(s):  
Hydrops Fetalis ◽  
The Many ◽  
Nonimmune Hydrops

Lysosomal Storage Disorders as an Etiology of Nonimmune Hydrops Fetalis: A Systematic Review

2021 ◽  
Author(s):  
Neel S. Iyer ◽  
Alexis C. Gimovsky ◽  
Carlos R. Ferreira ◽  
Elizabeth J. Critchlow ◽  
Huda B. Al‐kouatly
Keyword(s):  
Systematic Review ◽  
Lysosomal Storage Disorders ◽  
Hydrops Fetalis ◽  
Lysosomal Storage ◽  
Nonimmune Hydrops ◽  
Storage Disorders

High diagnosis rate for nonimmune hydrops fetalis with prenatal clinical exome from the Hydrops-Yielding Diagnostic Results of Prenatal Sequencing (HYDROPS) Study

2021 ◽  
Author(s):  
Huda B. Al-Kouatly ◽  
Mona M. Makhamreh ◽  
Stephanie M. Rice ◽  
Kelsey Smith ◽  
Christopher Harman ◽  
...  
Keyword(s):  
Hydrops Fetalis ◽  
Diagnosis Rate ◽  
Nonimmune Hydrops

Atrial Appendage Transcriptional Profile in Patients with Atrial Fibrillation with Structural Heart Diseases

2006 ◽  
Vol 1091 (1) ◽  
pp. 205-217 ◽  
Author(s):  
MARIA S. KHARLAP ◽  
ANGELICA V. TIMOFEEVA ◽  
LUDMILA E. GORYUNOVA ◽  
GEORGE L. KHASPEKOV ◽  
SERGEY L. DZEMESHKEVICH ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Diseases ◽  
Transcriptional Profile ◽  
Atrial Appendage ◽  
Structural Heart Diseases

scholarly journals Identification and prognostication of the substrate of ventricular arrhythmia with cardiac magnetic resonance (CMR) imaging in patients with normal echocardiography

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
S Younus ◽  
H Maqsood ◽  
A Gulraiz ◽  
MD Khan ◽  
R Awais
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Cardiac Magnetic Resonance ◽  
Chest Pain ◽  
Magnetic Resonance ◽  
Ventricular Arrhythmia ◽  
Heart Diseases ◽  
Sustained Ventricular Tachycardia ◽  
Structural Heart Diseases ◽  
Cmr Imaging

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): Self Introduction Malignant ventricular arrhythmia contributes to approximately half of the sudden cardiac deaths. In common practice, echocardiography is used to identify structural heart diseases that are the most frequent substrate of VA. Identification and prognostication of structural heart diseases are very important as they are the main determinant of poor prognosis of ventricular arrhythmia. Purpose : The objective of this study is to determine whether cardiac magnetic resonance (CMR) may identify structural heart disease (SHD) in patients with ventricular arrhythmia who had no pathology observed on echocardiography. Methods : A total of 864 consecutive patients were enrolled in this single-center prospective study with significant ventricular arrhythmia. VA was characterized as >1000 ventricular ectopic beats per 24 hours, non-sustained ventricular arrhythmia, sustained ventricular arrhythmia, and no pathological lesion on echocardiography. The primary endpoint was the detection of SHD with CMR. Secondary endpoints were a composite of CMR detection of SHD and abnormal findings not specific for a definite SHD diagnosis. Results : CMR studies were used to diagnose SHD in 212 patients (24.5%) and abnormal findings not specific for a definite SHD diagnosis in 153 patients (17.7%). Myocarditis (n = 84) was the more frequent disease, followed by arrhythmogenic cardiomyopathy (n = 51), ischemic heart disease (n = 32), dilated cardiomyopathy (n = 17), hypertrophic cardiomyopathy (n = 12), congenital cardiac disease (n = 08), left ventricle noncompaction (n = 5), and pericarditis (n = 3). The strongest univariate and multivariate predictors of SHD on CMR images were chest pain (odds ratios [OR]: 2.5 and 2.33, respectively) and sustained ventricular tachycardia (ORs: 2.62 and 2.21, respectively). Conclusion : Our study concludes that SHD was able to be identified on CMR imaging in a significant number of patients with malignant VA and completely normal echocardiography. Chest pain and sustained ventricular tachycardia were the two strongest predictors of positive CMR imaging results. Abstract Figure. Distribution of different SHD

The impact of physical exercise on the occurence of arrhythmias in athletes – recommendations

2018 ◽  
Vol 1 (46) ◽  
pp. 11-15
Author(s):  
Jakub Szwed ◽  
Michał Kowara ◽  
Marcin Grabowski
Keyword(s):  
Physical Exercise ◽  
Heart Diseases ◽  
Sudden Cardiac Arrest ◽  
Endurance Sports ◽  
Endurance Sport ◽  
Sport Training ◽  
Negative Results ◽  
Structural Heart Diseases ◽  
Long Time ◽  
The Impact

The aim of this article is to demonstrate the impact of physical exercise on the development of arrhytmias in athletes. The studies show that this relation exist and concerns endurance sports practiced for a long time. In addition, this article contains review of the most common arrhythmias in athletes and appropriate recommendations. The time of arrhythmias onset depends on the presence of structural heart diseases. If the cardiac disorder is absent the arrhythmias appear at the age 40-50. If the structural heart diseases exist, the arrhythmias occur in young athletes and are more dangerous (can lead to sudden cardiac arrest). The most common arrhythmia in endurance athletes is atrial fibrillation. In order to avoid negative results of endurance sports, such as cardiac arrhythmias, the reliable examinations are necessary, especially to exclude structural cardiac diseases. These examinations should be undertaken before initiation of endurance sport training and routinely later, in course of follow-up.

Diagnostic value of assessment of coronary calcification in dysplastic heart

2021 ◽  
Vol 19 (1) ◽  
pp. 75-77
Author(s):  
L. T. Pimenov ◽  
◽  
V. V. Remnyakov ◽  
M. Yu. Smetanin ◽  
E. N. Avdeev ◽  
...  
Keyword(s):  
Connective Tissue ◽  
System Development ◽  
Heart Diseases ◽  
Coronary Calcification ◽  
Diagnostic Value ◽  
Conduction Disorders ◽  
Increased Risk ◽  
Structural Heart Diseases ◽  
Connective Tissue Dysplasia ◽  
Functional Features

The problem of heart connective tissue dysplasia syndrome is extremely relevant due to the increased risk of rhythm and conduction disorders, infectious endocarditis, thromboembolism and sudden cardiac death (SCD). Structural heart diseases (SHD) are manifestations of minor anomalies of the cardiovascular system development. Dysplastic heart refers to the combination of constitutional, topographical, anatomical, and functional features of the heart in a patient with connective tissue dysplasia (CTD). The standard for the diagnosis of coronary calcification (CC), one of the known predictors of coronary heart disease (CHD) and complications of cardiovascular diseases (CVD), is multispiral computed tomography (MSCT).

scholarly journals The Changing Paradigm in the Treatment of Structural Heart Disease and the Need for the Interventional Imaging Specialist

2016 ◽  
Vol 11 (2) ◽  
pp. 135
Author(s):  
Nina C Wunderlich ◽  
Harald Küx ◽  
Felix Kreidel ◽  
Ralf Birkemeyer ◽  
Robert J Siegel ◽  
...  
Keyword(s):  
Heart Disease ◽  
Heart Diseases ◽  
Three Dimensional ◽  
Structural Heart Disease ◽  
Percutaneous Treatment ◽  
Interventional Imaging ◽  
Key Factor ◽  
Structural Heart Diseases ◽  
Specialist Standard ◽  
Contrast Ventriculography

Percutaneous interventions in structural heart diseases are emerging rapidly. The variety of novel percutaneous treatment approaches and the increasing complexity of interventional procedures are associated with new challenges and demands on the imaging specialist. Standard catheterisation laboratory imaging modalities such as fluoroscopy and contrast ventriculography provide inadequate visualisation of the soft tissue or three-dimensional delineation of the heart. Consequently, additional advanced imaging technology is needed to diagnose and precisely identify structural heart diseases, to properly select patients for specific interventions and to support fluoroscopy in guiding procedures. As imaging expertise constitutes a key factor in the decision-making process and in the management of patients with structural heart disease, the sub-speciality of interventional imaging will likely develop out of an increased need for high-quality imaging.

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