Late Coarctation Presenters Suffer Chronic Hypertension Resisting to Medicine Treatment

Petropoulos, Andreas; Moschovi, Maria; Khudiyeva, Aynur; Garayev, Fahraddin; Isayev, Ibrahim

doi:10.28942/ejcs.v1i4.35

Cited by 6 publications

(8 citation statements)

References 21 publications

(50 reference statements)

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“…As aforementioned, CHD carry a high incidence rate and actual number of children worldwide suffering -mostly in countries with high fertility rate-is dramatical increasing. The 2007-2009 World Society for Pediatric Heart Surgery Manpower Survey noted that about 75% of the world's population has no access to cardiac surgery, and that the distribution of cardiac surgeons was very unbalanced worldwide [8][9][10][11][12][13]. We have demonstrated above the variety of available methods.…”

Section: Discussionmentioning

confidence: 84%

“…We have demonstrated above the variety of available methods. These start from low cost and easy to apply measures, such as avoidance of teratogenic elements or conditions, continue with screening family history for CHD risk factors and reach to a good surveillance of the pregnancy -avoiding under or over nutrition-and delivering a diet rich in folic acid, minerals and vitamins [5][6][7][8][9][10][11][12][13][14][15][16]. In the early 1980's the introduction of fetal echo-2D, seemed to be the ultimate method in detecting CHD.…”

Section: Discussionmentioning

confidence: 99%

“…With this term we are indicating a subcategory of CHD in which early diagnosis and interventional/surgical treatment must be offered in the first month of life to avoid serious morbidity or death. In this group we in cloud all the complex cyanotic defects, the systemic and pulmonary ductus arteriosus depending circulations and the severe LV outflow tract obstruction conditions [2,4,9]. Table 1 summarizes all current methods of Prevention/Early detection of CHD in a chronological order.…”

Section: Methodsmentioning

confidence: 99%

“…Few CHD, for example: valve lesions of Marfan's or Ehlers -Danlos syndromes, left ventricular (LV) obstruction due to hypertrophic Cardiomyopathy [8], and late presenters of moderate size atrial septal defects or coarctation of the aorta that can be found in any stage of life masquerading as hypertension [9]. Not to forget the very common bicuspid aortic valves that can present later in life with stenosis and/or regurgitation [8,9]. Another important issue is the relation incidentbirth rates: Is the incident number universal or do countries with higher births by year having a higher incidence?…”

Section: Introductionmentioning

confidence: 99%

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Prevention and Early Detection of Congenital Heart Defects. Where do we Stand

Petropoulos¹

2018

OAJC

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Introduction: Since the origin of Medicine in 4 th BC. Century research has taught us that learning and practicing preventive medicine is properly the best method to prevent disease from happening in the first place. Preventive health care must be planned and executed ahead of time, even when illness/ disease, is absent, especially for those that are common and fetal. Among neonates and infants, congenital heart disease (CHD) is responsible for the largest proportion of mortality caused by birth defects. Actual numbers of patients and mortality resulting from CHD reportedly is increasing. In the developed world the treatment of CHD has escalating costs for health care systems and private covered patients, while in low-income countries it is not always available. Prevention is urgently needed to tackle the increasing needs. Aim: To present the current practice in preventing/early detecting CHD and justify why pulse oximetry is the best available, early detecting postnatal screening test we currently have. Methods: The existing in use preventing/early detecting methods for avoiding or early diagnosing CHD are: 1. Eliminate the maternal risk factors by obtaining a good level of health and medical surveillance during pregnancy. 2. Avoiding teratogenic agents, 3. Detecting risk factors from Family History, 4. Delivering a balanced Nutrition during Pregnancy 5. Obtaining at least an experienced 4-chamber view and outflow tracts imaging during the 20-weeks anomaly scan. 6. Fetal Echocardiography when indicated 7. Postnatal evaluation by experienced Pediatricians. 8. Pulse Oximetry, screening test after 72 hours post-delivery in term babies.9. Hyperoxia test when indicated. Conclusion: Although CHD's are the most common, high morbidity and mortality, congenital malformations, we still lack a single, easy to apply, non-invasive and low-cost screening test, for prevention/early detection. The current preventive methods must be combined to counterbalance the CHD prevalence. Meanwhile, they are costly and partially accessible. The most advantageous method for minimizing CHD deaths worldwide seems to be currently, pulse oximetry combined with clinical assessment.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevention and Early Detection of Congenital Heart Defects. Where do we Stand

Petropoulos¹

2018

OAJC

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“…Surprisingly, coarctation of the aorta was rarely detected by examination of femoral artery pulsation in the study region. This examination is a screening test and the gold standard for the clinical detection of this defect [34]. Coarctation is the most common CHD that may not be diagnosed until adolescence or adulthood [35].…”

Section: Basic Evaluationmentioning

confidence: 99%

First symptoms of prenatally undetected heart defects

Pavlíček

Klásková

Kaprálová

et al. 2020

Preprint

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Background: Severe or critical congenital heart defects (CHDs) are 35% of those detected only after birth. The aim of the study was to measure the incidence of these CHDs, identify their clinical symptoms, and determine individual risk periods for CHD manifestation. Methods: This retrospective cohort study was conducted from 2009 to 2018 in a population of 175,153 live births. Occurrence of the first symptoms of CHD was noted as early neonatal (0–7 days), late neonatal (8–28 days), in early infancy (1–6 months), or in late infancy (6–12 months). The first symptom for which the child was referred to a pediatric cardiologist was defined as a symptom of CHD. Results : There were 598 severe CHDs diagnosed (3.3 cases/1000), and 70% were isolated anomalies. A concomitant genetic disorder was diagnosed in 20%, and extracardiac pathology with a normal karyotype was present in 10%. Of the total, 53% of CHDs were detected prenatally and excluded. The remaining 47% developed CHD symptoms postnatally. Of these, 74% were diagnosed as early neonates, 16% as late neonates, and 10% as infants. Defects requiring repeated operations manifested significantly earlier than those with requiring one primary correction. The most common symptoms leading to the diagnosis of CHD were heart murmur and cyanosis. Conclusions : Despite the effectiveness of prenatal diagnosis, some children will be born with undiagnosed major heart defects. Assessment of symptoms and early detection of the defect is crucial.

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Major heart defects: the diagnostic evaluations of first-year-olds

et al. 2021

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Background Severe or critical congenital heart defects (CHDs) constitute one third of the heart defect cases detected only after birth. These prenatally unrecognised defects usually manifest as cyanotic or acyanotic lesions and are diagnosed postnatally at various times. The aim of the study was to identify their clinical symptoms and determine individual risk periods for CHD manifestation. Methods Data were assessed retrospectively based on a cohort of patients born between 2009 and 2018 in a population of 175,153 live births. Occurrence of the first symptoms of CHD was classified into: early neonatal (0–7 days), late neonatal (8–28 days), early infancy (1–6 months), or late infancy (6–12 months). The first symptom for which the child was referred to a paediatric cardiologist was defined as a symptom of CHD. Results There were 598 major CHDs diagnosed in the studied region, 91% of which were isolated anomalies. A concomitant genetic disorder was diagnosed in 6% of the cases, while 3% presented extracardiac pathology with a normal karyotype. In total, 47% (282/598) of all CHDs were not identified prenatally. Of these, 74% (210/282) were diagnosed as early neonates, 16% (44/282) as late neonates, and 10% (28/282) as infants. The most common symptoms leading to the diagnosis of CHD were heart murmur (51%, 145/282) and cyanosis (26%, 73/282). Diagnosis after discharge from the hospital occurred in 12% (72/598) of all major CHDs. Ventricular septal defect and coarctation of the aorta constituted the majority of delayed diagnoses. Conclusions In conclusion, murmur and cyanosis are the most common manifestations of prenatally undetected CHDs. Although most children with major CHDs are diagnosed as neonates, some patients are still discharged from the maternity hospital with an unidentified defect.

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Late Coarctation Presenters Suffer Chronic Hypertension Resisting to Medicine Treatment

Cited by 6 publications

References 21 publications

Prevention and Early Detection of Congenital Heart Defects. Where do we Stand

Prevention and Early Detection of Congenital Heart Defects. Where do we Stand

First symptoms of prenatally undetected heart defects

Major heart defects: the diagnostic evaluations of first-year-olds

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