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

Fourteen term newborn infants have been recognized as having transient tricuspid insufficiency associated with significant perinatal stress. Five of these infants underwent cardiac catheterization for presumed congenital heart disease, but had only massive tricuspid valve insufficiency. The other nine infants were diagnosed on the basis of a murmur characteristic of tricuspid valve insufficiency and on other clinical grounds. All had a history of significant perinatal stress in the form of asphyxia with or without hypoglycemia. Frequently, congestive heart failure, persistent cyanosis, and ECG evidence of myocardial ischemia were present. Twelve of the 14 survived, and in each of them all cardiac signs and symptoms, including the murmur, spontaneously resolved. The two patients who died had histopathologic evidence of necrosis in the anterior papillary muscle of the tricuspid valve. The constant features of perinatal stress, ST-T wave abnormalities on the ECG, and spontaneous resolution of the transient tricuspid insufficiency strongly suggest that this syndrome is secondary to a reversible form of myocardial dysfunction, perhaps by affecting papillary muscle specifically. We believe that hypoxia with or without hypoglycemia precipitates the events leading to this clinical syndrome which is distinguishable from other cardiac abnormalities in the newborn by the history, distinctive murmur, and the ECG abnormalities.
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PMID:Transient tricuspid insufficiency of the newborn: a form of myocardial dysfunction in stressed newborns. 13 40

The authors have followed up 26 children suffering from severe scoliosis associated with congenital heart disease up to the end of puberty. The curve was usually a very severe idiopathic scoliosis developing early and requring surgical treatment. Two types may be distinguished: I. Scoliosis without excessive surgical risk, in patients in whom the heart disease is not associated with cyanosis or where the heart condition has already been treated surgically and in which there are no clinical, radiological or electrical signs of cardiac failure. 2. Scoliosis with considerable surgical risk because of heart disease with cyanosis not treated surgically, or with signs of heart failure or pulmonary hypertension. In such cases, the surgical treatment of the scoliosis is likely to endanger life.
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PMID:[Scoliosis and congenital cardiopathies]. 13 60

Echocardiography is an important noninvasive method for accurately diagnosing many congenital cardiac defects. This method provides significant information so that cardiac surgery, when necessary, can be planned with greater facility. The value of the sonar method rests not only on its ability to diagnose specific cardiac defects but also to exclude heart disease, especially in infants with shock or cyanosis from noncardiac causes. Development of two-dimensional real-time scanning systems should provide greater understanding of anatomic spatial relationships and ease of diagnosis.
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PMID:Echocardiography in congenital heart disease. An aid to surgical diagnosis. 32 31

Differential diagnosis of cyanosis in the neonate is difficult and cardiac catheterisation may be required for a correct diagnosis. It has been suggested that the response of PaO2 to continuous positive airway pressure (CPAP) with 100% oxygen may be useful. The purpose of this study was to test further this hypothesis by studying all neonates investigated for cyanosis with a PaO2 less than or equal to 50 torr in 0-8 to 1-0 F1O2. Arterial blood samples were obtained in an F1O2 of 0-21-0-4 and 0-8-1-0, and in an F1O2 of 0-8-1-0 with 8-10 cm CPAP, and were analysed for PaO2, PaCO2, and pH, bicarbonate being calculated. The final diagnoses were congenital heart disease (CHD) 21 cases, pulmonary parenchymal disease (PD) 10 cases, and persistent fetal circulation (PFC) 3 cases. No significant difference in pH, bicarbonate, or PaCO2 was observed among the three groups or with CPAP. In the CHD and PFC infants CPAP produced no significant change in PaO2. In the PD babies PaO2 increased by an average of 33 torr (P less than 0-05). Despite thus attaining statistical significance 2 PD infants had no increase in PaO2 with CPAP. An increase of PaO2 greater than 10 torr with CPAP suggests PD, and a nonsignificant increase in PaO2 does not rule out PD. Irrespective of initial PaO2, final PaO2 in 0-8-1-0 F1O2 with CPAP greater than 50 torr suggests PD, and less than 50 torr suggests CHD. The results indicate that CPAP may be used as an adjunct in differentiating cardiac from pulmonary disease.
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PMID:Usefulness of continuous positive airway pressure in differential diagnosis of cardiac from pulmonary cyanosis in newborn infants. 35 48

Persistence of the fetal circulation is a recently recognized cause of severe cyanosis in newborn full term infants. Abnormally elevated pulmonary vascular resistance apparently stimulated by hypoxia, acidosis, and/or hyperviscosity results in cyanosis due to large right-to-left shunts through persistent fetal channels (patent foramen ovale and patent ductus arteriosus). Initial chest radiographs demonstrate clear lungs, decreased, normal, or mildly prominent pulmonary vascularity, and normal to moderately enlarged cardiac silhouettes. Angiocardiography, when required to rule out cyanotic congenital heart disease, demonstrates normal intracardiac anatomy, normal great vessel relationships, and right-to-left shunting across the patent foramen ovale and patent ductus arteriosus. Significant tricuspid regurgitation occurs in some of these infants, associated with variable right ventricular dilatation; the left ventricle is normal. The majority of babies with this condition ultimately survive. Treatment consists of intensive care including oxygen therapy and correction of acidosis. Vasodilators such as tolazoline may be helpful.
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PMID:Persistence of the fetal circulation: radiologic considerations. 40 2

The earlier detection and investigation of babies with congenital structural heart disease has resulted in earlier treatment and better management of these patients. In 1965, at the Hospital for Sick Children, Toronto, 121 cases were assessed and treated; by 1975 this figure had risen to 226 cases. Few changes were noted in the incidence of the 10 most common malformations, except for the obvious increase in the incidence of patient ductus arteriosus due to survival of increasingly premature infants. The sick cardiac neonate was referred earlier in 1975, studied with newer non-invasive investigations, and, according to the severity of symptoms and signs, was sent sooner to cardiac catheterisation. 80% of babies presenting with cyanosis survived the first month and 60% of babies with congestive heart failure survived. With better surgery and perioperative care, the survival rate in the first month after surgery rose from 37% in 1965 to 70% in 1975.
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PMID:Structural heart disease in the newborn. Changing profile: comparison of 1975 with 1965. 45 12

A case of pulmonary arteriovenous fistula associated with rheumatic mitral heart disease is presented. We have reviewed the literature and no published case with such association has been described. The loud mitral insufficiency murmur hide the continuous murmur of the fistula. The angiographic study demonstrated the A-V fistula. Retrospectively the diagnosis should have been suspected due to cyanosis, slight clubbing, the radiologic findings and the important Qs/Qt shunt. The associated pulmonary embolic phenomena made more difficult the diagnosis.
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PMID:[Arteriovenous fistula and rheumatic cardiopathy]. 47 2

Eighteen infants carrying pulmonary stenosis with a complete interventricular wall whose most frequent clinical data are: precocius cyanosis, congestive cardiac insufficiency and in 25% of them hypoxic crises are presented. Complementary explorations of this entity are not definitive, but clinical diagnosis described with evolutional cardiomegaly at the expense of the right cavities and pulmonary ischemia forces authors to think that there is a severe obstruction of the infumdibulum with complete interventricular septum. The different parameters which have been proposed to evaluate severity of the stenosis are discussed and compared, finding among them significative differences. Authors consider the concept of the right diminutive ventricle, finding in these cases the electrocardiographic pattern rS in V1 and observing a great mortality both spontaneous and postsurgical. The high mortality of this heart disease, both in its' natural evolution as well as after surgery is to be pointed out as in most published series.
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PMID:[Critical pulmonary stenosis in infants (author's transl)]. 50 75

Disturbances of heart rhythm, observed during 700 heart catheterizations in infants and children, are discussed. Paroxysmal supraventricular tachycardia has been observed in 25 investigations (3,6%), sinus bradycardia in 18 (2,6%), junctional rhythm in 10 (1,4%), second degree AV-block in 9 (1,3%), ventricular fibrillation in 8 (1,1%), sinus tachycardia in 7 (1%), complete block in 7 (1%), asystole and atrial flutter in 2 (0,3%) each, and ventricular tachycardia in 1 (0,15%). Supraventricular tachycardia occurred equally in all ages without preference of a special malformation. The two patients with WPW-syndrome, however, showed this disorder in each of three catheterizations. Propranolol and verapamil succeeded in terminating the attacks. Junctional rhythm and sinus tachycardia presented equal behavior and benignity. Sinus bradycardia, second and third degree AV-block, and especially ventricular fibrillation occurred mostly in neonates and infants, many of them cyanotic and suffering from complex malformations and therefore needing multiple catheter manipulations. Bradycardia was in two, asystole in one of the very sick neonates associated with subsequent death within 24 hours. Once asystole resulted in immediate death after pulmonary angiography in a child with severe pulmonary hypertension. Ventricular fibrillation could be terminated promptly by DC countershock in all patients, but three of the children died subsequently. Complete block occurred only in children with systemic right ventricular pressure, 4 of the 7 patients having pulmonary hypertension, too. In two instances the block subsided spontaneously, the rest could successfully be treated with orciprenaline (Alupent R). Life threatening arrhythmias became less frequent as a consequence of earlier investigation, if severe heart disease was suspected, and by closer control of cyanosis, acidosis and temperature before, during, and after catheterization.
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PMID:[The risks involved in the heart catheter examination. A retrospective evaluation of the complications after 700 examination. III. Irregularities of heart (author's transl)]. 53 Jul 27

A young woman with hypoplastic right heart syndrome developed a carotid body tumor at age 28. High altitude habitation is known to predispose to hyperplastic and neoplastic carotid bodies; emphysema and congenital cyanotic heart disease have recently been shown to induce hyperplasia of this oxytrophic tissue. Therefore, a link between congenital cyanosis and carotid body tumor is suggested by this patient. Carotid bodies are nonchromaffin paraganglionic analogues of the adrenal medulla. Congenital cyanosis has an association with pheochromocytoma. In the cyanotic milieu carotid body tumor may be a histological analogue of pheochromocytoma.
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PMID:Cyanotic heart disease: "low altitude" risk for carotid body tumor? 62 92


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