Malnutrition and growth failure in cyanotic and acyanotic congenital heart disease with and without pulmonary hypertension

Abstract

Aim-To investigate the eVect of several types of congenital heart disease (CHD) on nutrition and growth. Patients and methods-The prevalence of malnutrition and growth failure was investigated in 89 patients with CHD aged 1−45 months. They were grouped according to cardiac diagnosis: group aP (n = 26), acyanotic patients with pulmonary hypertension; group ap (n = 5), acyanotic patients without pulmonary hypertension; group cp (n = 42), cyanotic patients without pulmonary hypertension; and group cP (n = 16), cyanotic patients with pulmonary hypertension. Information on socioeconomic level, parental education status, birth weight and nutrition history, number of siblings, and the timing, quality, and quantity of nutrients ingested during weaning period and at the time of the examination were obtained through interviews with parents. Results-There was no significant diVerence between groups in terms of parental education status, socioeconomic level, duration of breast feeding, and number of siblings (p > 0.05). Group cP patients ingested fewer nutrients for their age compared to other groups. 37 of the 89 patients were below the 5th centile for both weight and length, and 58 of 89 patients were below the 5th centile for weight. Mild or borderline malnutrition was more common in group aP patients. Most group cp patients were in normal nutritional state, and stunting was more common than wasting. Both moderate to severe malnutrition and failure to thrive were more common in group cP patients. Conclusion-Patients with CHD are prone to malnutrition and growth failure. Pulmonary hypertension appears to be the most important factor, and cyanotic patients with pulmonary hypertension are the ones most severely aVected. This study shows the additive eVects of hypoxia and pulmonary hypertension on nutrition and growth of children with CHD. (Arch Dis Child 1999;81:49-52)

Cardiopatias congênitas em um serviço de referência: evolução clínica e doenças associadas

“…According to literature, among cyanotic patients, those patients with pulmonary arterial hypertension were the most severely affected with weight delay 13 . Evidences show, without classifying patients in cyanotic or non-cyanotic congenital heart disease, that height and weight at birth and during this study and height and weight growth of patients with congenital heart disease were lower when compared to healthy children 2 .…”

Oral-dental hygiene and oral microorganisms in children with and without congenital heart disease

“…Varan et al, in their study in children with cyanotic and acyanotic CHD in 1996-1997, reported that 65% of the children were below the 5 th percentile for weight, and 41% were below the 5 th percentile for both weight and height. 9 In the early 1930s, an expanding body of literature documented bacteremia after a wide variety of dental procedures, including tooth brushing and chewing, in uninfected mouths. 10,11 Prophylaxis is particularly important for children because endocarditis is still associated with high morbidity and mortality.…”

Nutritional Approach of Pediatric Patients Diagnosed with Congenital Heart Disease

“…Decreased caloric intake has been shown to be the most important cause of malnutrition in pediatric patients with CHD [7]. A study published by Hansen and Dorup [8] showed that caloric intake in patients with CHD was 76% that of normal age-matched controls.…”