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Query: UMLS:C0018799 (heart disease)
34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Congenital heart disease represents about 5% of all cardiovascular diseases in Nigeria today. Its incidence has increased in the last decade because of improved neonatal care, increased awareness and clinical acumen of physicians, better diagnostic tools and the introduction of newer techniques in cardiac catheterization. It is now possible to make the diagnosis with certainty and to define the extent of the pathology thus making it possible to select the appropriate surgical therapy for these children. This article reviews the commonest types of noncyanotic heart disease, the indications for surgery and the types of surgical procedures available in Nigeria today. The simple extracardiac defects, such as patent ductus arteriosus and coarctation of the aorta can be corrected with little or no mortality, but the more complex intracardiac defects can only be palliated pending the introduction of open heart surgery in Nigeria.
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PMID:Surgery for congenital heart disease in Ibadan. I: Non-cyanotic heart defects. 75 54

A survey was carried out amongst 7062 people of different age groups in Dacca city and in a village. It was found that 207 (2.92%) persons had some sort of heart disease. Hypertension was present in 83 (1.10%) persons. Rheumatic heart disease, ischaemic heart disease and cardiac arrhythmia were detected in 53 (0.75%), 24 (0.33%) and 16 (0.22%) persons respectively. Congenital heart disease was found in 13 (0.18%) individuals, and 18 (0.25%) persons were suffering from cardiomypathy or corpulmonale. Rheumatic heart disease was common in poor people of younger age. More ischaemic heart disease was found in well-to-do people but poor people were not immune from this.
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PMID:Congenital and acquired heart diseases: (A survey of 7062 persons). 103 68

The social status of 71 young adults (30 females, 41 males, aged 22.9 +/- 1.9 yr) with congenital heart disease was compared with that of 211 (106 females, 105 males, mean age 23.2 +/- 1.4 yr) randomly selected controls. The clinical examinations included clinical study with ultrasonic visualization, electrocardiography, X-ray and measurement of exercise capacity. In the study group 87% had completed school at the secondary level and another 21% at high school level, while the corresponding figures in the control group were 98% and 51%. About half of both groups continued to vocational training and a fifth to a higher level. Those without any vocational education made up 32% of the study group (95% confidence interval 21-43%) and 11% of the controls (95% confidence interval 7-15%). State benefits were the main source of income for 13% of the study group as compared to 2% among the controls. The employment status of the actual labour force showed no significant difference between the groups. Among patients with congenital heart disease there were significantly more of those who had developed a dependent life style, living with their parents without a marital or quasi-marital relationship. A cyanotic type of severe heart defect is one of the factors predisposing to poor success at school and a dependent lifestyle. Congenital heart disease, even when treated, is a significant factor which influences adult life. The results call for more practical support to assist psychosocial maturation, especially in patients with residual defects.
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PMID:Social adaptation of young adults with congenital heart disease. 142 49

Congenital heart disease impedes developmental tasks associated with adolescence. Thus nurses need to conduct sensitive counseling with adolescents with congenital heart disease. These adolescents see themselves as different and embrace attitudes and behaviors of peers even when some behaviors pose likely health risks. To gain control over their lives and be able to make decisions, they must be familiar with their cardiac condition and complete health care needs. They also view their physical condition as worse than medically indicated. Nurses should counsel each student about sports participation based on an individual basis. Adolescents who have undergone successful cardiac repair for ventricular septal defect, atrial septal defect secundum, endocardial cushion defect (incomplete), and patent ductus arteriosus can participate in competitive sports. Adolescents tend to fear sexual arousal because the heart rate and blood pressure increase. Yet they tend to be as sexually active as their healthy peers. Most people with mild, unoperated heart disease or successfully repaired defects are likely to have a normal pregnancy and a healthy infant. The IUD is contraindicated. Oral contraceptives (OCs) tend to be safe especially progestin-only OCs. Nurses should recommend barrier methods for conscientious users and sexual abstinence. The likelihood of a parent with congenital heart disease having a child with the same disease is higher than the general population, but it still is small. Genetic counseling must also include warnings about the effect of some cardiovascular medications on the developing fetus. Adolescents need vocational guidance to encourage them to pursue careers they want and steer them away from careers that are potentially harmful. Nurses should assess their feelings toward drugs and alcohol to help them choose not to use these substances. They should determine the quality of support systems available to adolescents with heart disease, recognize social concerns, and reinforce positive coping responses.
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PMID:Counseling adolescents with congenital heart disease. 155 87

Tetralogy of Fallot, the most common cyanotic heart defect, has not been closely associated with a specific chromosome defect. The San Luis Valley Recombinant Chromosome 8 [SLV Rec(8)] syndrome is strongly associated with congenital heart disease, particularly tetralogy of Fallot. This article reviews SLV Rec(8) syndrome and other chromosome 8 aberrations to suggest locations for cardiogenic genes. SLV Rec(8) [rec(8),dup q,inv(8)(p23q22)] syndrome has been found in Hispanic families in the southwestern United States. Congenital heart disease is found in 93.3% of SLV Rec(8) individuals (n = 45), with tetralogy of Fallot constituting 40.5% of all lesions and conotruncal defects, 55.6%. These frequencies exceed the incidence of tetralogy of Fallot (10%) and conotruncal defects (20%) among all children with heart defects (P less than 0.003 for both). Review of patients with deletion 8p (n = 13) showed heart defects in 84.6% with 27.3% being conotruncal defects. Among duplication 8q patients (n = 20), 45% had heart defects with conotruncal defects constituting 44%. Neither group differed significantly from expected in its incidence of conotruncal defects. Among patients with mosaic trisomy 8 (n = 47), 12 had heart abnormalities including one conotruncal defect. Among 3 patients with other rec(8) chromosomes, one had a ventricular septal defect. The cause of heart defects in SLV Rec(8) cannot be assigned to either the deletion of 8p or the duplication of 8q. The lack of an association between other chromosome 8 abnormalities and tetralogy of Fallot suggests that genes at the SLV Rec(8) breakpoints or an interaction between genes on both arms of chromosome 8 are important.
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PMID:San Luis Valley recombinant chromosome 8 and tetralogy of Fallot: a review of chromosome 8 anomalies and congenital heart disease. 174 13

The outcome and suitability for therapeutic interventions in children with congenital heart disease depend frequently on left ventricular function. Congenital heart disease is characterized by changes in loading conditions, making it difficult to assess ventricular contractility using conventional load-dependent indexes. Two-dimensional and M-mode echocardiography and arterial blood pressure were used to study left ventricular morphometrics and contractility in 44 normal children, aged 2 to 12 years. Left ventricular end-systolic and end-diastolic length, diameter, wall thickness, volume and mass all showed linear increases with body surface area (p less than 0.001 in all). Shortening and ejection fractions, velocity of circumferential fiber shortening, morphometric ratios and endocardial meridional and circumferential stress (mean 46 and 115 g/cm2, respectively) all remained constant. A load-independent measure of the normal resting left ventricular contractile state was determined by relating the rate-corrected velocity of circumferential fiber shortening to end-systolic endocardial meridional and circumferential stress; there was an inverse linear correlation (r = -0.641 and -0.557 respectively, p less than 0.001). These data provide a quantitative basis for assessment of myocardial hypertrophy, afterload and contractile state in childhood.
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PMID:Normal values for noninvasive estimation of left ventricular contractile state and afterload in children. 213 67

Congenital heart disease as a complicating factor in pregnancy has assumed increasing clinical importance because improved techniques of surgical repair have resulted in a larger proportion of affected women living to the reproductive age. The most serious forms are those associated with pulmonary hypertension (such as the Eisenmenger syndrome), which carry a prohibitively high risk of maternal death. Complex forms of cyanotic heart disease, of which the commonest is the tetralogy of Fallot, are only slightly less dangerous. It has recently been recognized that children born to women with congenital heart disease are at increased risk of having cardiac defects; fetal echocardiography is therefore an important diagnostic test. Optimal care of the pregnant woman with congenital heart disease is best provided by a team consisting of internist-cardiologist, obstetrician-perinatologist, obstetric anesthesiologist, and ultrasonographer-echocardiographer.
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PMID:Pregnancy and congenital heart disease. 217 37

The authors report a case of fetal supraventricular tachycardia with the heart rate of 400/min diagnosed in the 34th week of pregnancy. Congestive heart failure forming non immun hydrops fetalis was occurred by this rhythm disturbance. With digitalis and beta receptor blocker propranolol therapy administered to the mother the rhythm disturbance has stopped, ascites and hydrothorax secondary to fetal congestive heart failure have been abolished. Congenital heart disease and cardiomyopathy were excluded by fetal echocardiography. In the 40th week a healthy newborn was delivered by cesarean section and after delivery congenital heart disease, rhythm disorder, infection or metabolic disturbance couldn't be verified. The authors reviewing the literature demonstrate the suggested investigating procedures and the possibilities of therapy in the case of fetal supraventricular tachycardia.
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PMID:[Intrauterine treatment of fetal tachycardia causing circulatory failure]. 218 48

Congenital heart disease as an indication for heart transplantation accounts for a small number of the total heart transplant experience--less than 3% in most centers. We have performed heart transplantation in eight such patients, accounting for 4% of our total experience. All these patients had specific anatomic anomalies relevant to transplantation. None had morbidity directly related to their anatomic defect and subsequent transplant. Six of the eight had undergone no prior palliative or corrective repairs. One child had a left Blalock-Taussig shunt, and one had bilateral Glenn shunts and a Fontan repair. Technical considerations for orthotopic heart transplantation are described for transposition of the great arteries, left superior vena cava with and without bridging innominate vein, common atrium, presence of Blalock-Taussig shunt, bilateral Glenn shunts, and Fontan repair. Anatomic congenital heart disease is becoming a more frequent indication in heart transplantation. Heart transplantation in the presence of structural congenital heart disease may be technically challenging. Nevertheless, transplantation offers an effective therapeutic alternative for patients with end-stage congestive heart failure and congenital heart disease.
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PMID:Special considerations for heart transplantation in congenital heart disease. The Paediatric Heart Transplant Group. 227 95

Congenital heart disease occurred in 64% of patients with the CHARGE (coloboma, heart disease, choanal atresia, retardation of postnatal growth and mental development, genitalia hypoplasia, and ear anomalies) association (55% of 67 previously described patients and 100% of 16 new patients). Of those with congenital heart disease, 42% had conotruncal anomalies (tetralogy of Fallot, double-outlet right ventricle, truncus arteriosus), and 36% had aortic arch anomalies (vascular ring, aberrant subclavian artery, interrupted aortic arch). This striking pattern of cardiovascular malformations is similar to that found in the DiGeorge sequence.
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PMID:The pattern of cardiovascular malformation in the CHARGE association. 244 95


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