Congenital Heart Disease: The State-of-the-Art on Its Pharmacological Therapeutics

Abstract

Congenital heart disease is one of the most common causes of death derived from malformations. Historically, its treatment has depended on timely diagnosis and early pharmacological and surgical interventions. Survival rates for patients with this disease have increased, primarily due to advancements in therapeutic choices, but mortality remains high. Since this disease is a time-sensitive pathology, pharmacological interventions are needed to improve clinical outcomes. Therefore, we analyzed the applications, dosage, and side effects of drugs currently used for treating congenital heart disease. Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, and potassium-sparing diuretics have shown a mortality benefit in most patients. Other therapies, such as endothelin receptor antagonists, phosphodiesterase-5 inhibitors, prostaglandins, and soluble guanylyl cyclase stimulators, have benefited patients with pulmonary artery hypertension. Likewise, the adjunctive symptomatic treatment of these patients has further improved the outcomes, since antiarrhythmics, digoxin, and non-steroidal anti-inflammatory drugs have shown their benefits in these cases. Conclusively, these drugs also carry the risk of troublesome adverse effects, such as electrolyte imbalances and hemodynamic compromise. However, their benefits for survival, symptom improvement, and stabilization outweigh the possible complications from their use. Thus, cases must be assessed individually to accurately identify interventions that would be most beneficial for patients.

Peranan ACE-Inhibitor pada penyakit jantung bawaan

“…Paling tidak terdapat 35 tipe defek yang teridentifikasi, yang terbanyak adalah ventricular septal defect (VSD) sekitar 20-25%, atrial septal defect (ASD) sekitar 8-13%, patent ductus arteriosus (PDA) 6-11% (tidak termasuk bayi prematur), dan koarktasio aorta sebanyak 5-7%. PJB memiliki berbagai macam komplikasi yang dapat terjadi, dari gagal jantung kongestif ringan sampai dengan hipoksemia berat dan syok (Varela-Chinchilla et al, 2022).…”

Stress Coping Strategies in Parents of Newborns and Infants with Congenital Cyanotic Heart Disease with Regard to Stress Levels and Negative Emotions

“…Similarly to other countries, in Poland, heart defects are the leading cause of death in children born with congenital defects [1,2]. The problem persists despite an increase in the efficiency of diagnosing congenital defects in newborns and infants, an increase in the number of cardiac surgeries [1], improved treatment standards, and a general increase in survival rates in this group [3][4][5][6].…”

Association of Congenital Heart Defects (CHD) with Factors Related to Maternal Health and Pregnancy in Newborns in Puerto Rico

“…CHD is one of the most common types of birth defects. It is the most common congenital malformation associated with the highest mortality among them [ 2 , 3 ]. In Puerto Rico, CHD is diagnosed in 9.5 out of 1000 live births [ 4 ].…”