Likewise, more recently, Hoffman et al 9 reported that, in the United States, between and , nearly 1. They made specific calculations of the expected survival for the different types of anomalies from patent ductus arteriosus to single ventricle or double-outlet right ventricle , without treatment and with treatment.
In any case, given that these values are broken down into five-year periods, the calculated percentage of survivors, especially with complex lesions, increased progressively and clearly from on, coinciding with the development of diagnostic and therapeutic techniques. In Spain, the situation clearly overlaps. While those authors confirmed that congenital cardiac anomalies were the cause of a high percentage of deaths in infants, they also observed that the mortality was lower in those born in the period from to as compared to those born between and , especially among children with ventricular septal defect or patent ductus arteriosus..
The data are convincing and lead us to foresee a progressive increase, over the coming years, in the number of adolescents and adults with congenital heart defects, often repaired but seldom "totally cured. They are not fully cured, which means that, periodically, they should have access to more or less specialized monitoring and, at least, the same level of technical, scientific and humanitarian assistance they received as children, a threshold that pediatric cardiologists have raised to considerable heights.. A new population, with new problems and new challenges, has been born. We should replace the expression "pediatric cardiology" with "cardiology of congenital heart disease," which demands fresh knowledge and an innovative structure and planning.
The patient with heart disease is ill prior to birth and remains so until his or her death. Thus, their monitoring should involve obstetricians, neonatologists, intensive care physicians, anesthesiologists, pediatric cardiologists, adult cardiologists, pediatric heart surgeons, adult heart surgeons, etc, while not forgetting molecular biologists, geneticists and physiologists, who should work in close collaboration with a common aim, that is, "the prevention, diagnosis, monitoring and treatment of congenital cardiac anomalies, regardless of the age of the patient.
Thus, reports that provide data on the real extent of the problem are of great importance, and are fundamental to a new approach to health care planning and organization in this field..
- Of Wanting and Rain: Collected Love Poems of Paul Hina 2007-2009;
- Grown-Up Congenital Heart Disease (Management of) Guidelines.
- Department of Health | Newborn Screening & Genetic Services | Critical Congenital Heart Defects?
- This Land is My Land.
- The Royal Quests (The Necromancer Wars Book 3);
- Newborn Screening & Genetic Services.
Correspondence: Dra. Hospital de la Santa Creu i Sant Pau. Antoni M. Claret, E-mail: msubiranad santpau. Home Articles in press Current Issue Archive. ISSN: Previous article Next article. Issue Pages December Download PDF.
This item has received. Article information. See article on pages We are all well aware of the important advances made in the realm of cardiology in recent years, but, undoubtedly, they have had a special impact in the realm of congenital heart disease. What areas should these resources be channeled into? The incidence rates reported up to that time had to be revised.
A Simple Guide to Medical Conditions, no. 48
Now, with the introduction of fetal 2D Doppler echocardiography, we perceive a new horizon in the technological armamentarium for prenatal diagnostics: the detection of cardiac anomalies during the different stages of pregnancy, with the possible impact that this can have, both in obstetrics and in perinatal and neonatal monitoring and management, a subject we will address in the next section.
Logically, if we want accurate incidence rates, the search to identify cases of congenital cardiac anomalies can not be limited to tertiary or referral centers, since that would imply the failure to include patients with the least severe defects. On the other hand, if the information is obtained retrospectively from the clinical records of pediatric primary care centers, undetected cases will not be included, some because the diagnostic suspicion did not arise in early childhood and others because the proper diagnostic techniques had not been employed. Therefore, it is necessary to clarify the terminology and to be aware of the information obtained, since it could be that resources that could be obviated in the treatment of congenital heart disease during childhood should not be eliminated, but be rechanneled toward systems of prevention or toward the fetal stage, in which the evaluation of invasive techniques for the treatment of certain heart defects has already begun.
In any case, this is not always easy since it makes it necessary to perform well-designed prospective studies in the search for the diagnosis. Likewise, although this is a matter of little or no practical impact, the report being retrospective, it is highly possible that the study did not include certain anomalies with no evident impact on hemodynamic function, the diagnosis of which involves a detailed search, such as small ductus arteriosus, persistent left superior vena cava, some cases of partial anomalous pulmonary venous drainage, etc.
The findings would help us to establish priorities in the distribution of resources. While those authors confirmed that congenital cardiac anomalies were the cause of a high percentage of deaths in infants, they also observed that the mortality was lower in those born in the period from to as compared to those born between and , especially among children with ventricular septal defect or patent ductus arteriosus. They are not fully cured, which means that, periodically, they should have access to more or less specialized monitoring and, at least, the same level of technical, scientific and humanitarian assistance they received as children, a threshold that pediatric cardiologists have raised to considerable heights.
Thus, reports that provide data on the real extent of the problem are of great importance, and are fundamental to a new approach to health care planning and organization in this field. J Am Coll Cardiol, 37 , pp. The incidence of congenital heart disease.. J Am Coll Cardiol, 39 , pp. Incidence of congenital heart disease: II.
Prenatal incidence.. Pediatr Cardiol, 16 , pp. Congenital heart disease in 56, births. Incidence and natural history..
A Simple Guide to Congenital Heart Diseases
Circulation, 43 , pp. Rev Esp Cardiol, 58 , pp. Trends in prenatal diagnosis, pregnancy termination, and perinatal mortality of newborns with congenital heart disease in France, a population-based evaluation.. Pediatrics, , pp. Survival with congenital heart disease and need for follow up in adult life.. Heart, 85 , pp. Mortality associated with congenital heart defects in the United States.
Trends and racial disparities, Circulation, , pp.
Bestselling in Congenital Heart Defect
Am Heart J, , pp. Rev Esp Cardiol, 54 , pp. Congresses Only available in Spanish. Subscribe to our newsletter. Print Send to a friend Export reference Mendeley Statistics. Usefulness of detector Computed Tomography in the Instructions for authors Submit an article Ethics in publishing Information for reviewers Frequently asked questions. Images subject to Copyright, to apply for permission to reprint, please contact spainpermissions elsevier.
However, most of the time doctors don't know why congenital heart defects develop. Heredity may play a role in some heart defects.
For example, a parent who has a congenital heart defect may be more likely than other people to have a child with the condition. In rare cases, more than one child in a family is born with a heart defect. Children who have genetic disorders, such as Down syndrome, often have congenital heart defects. In fact, half of all babies who have Down syndrome have congenital heart defects.
Smoking during pregnancy also has been linked to several congenital heart defects, including septal defects. Many congenital heart defects have few or no signs or symptoms. A doctor may not even detect signs of a heart defect during a physical exam. Some heart defects do have signs and symptoms.
Simple Congenital Heart Disease
They depend on the number, type, and severity of the defects. Severe defects can cause signs and symptoms, usually in newborns. These signs and symptoms may include:. Heart defects can cause abnormal blood flow through the heart that will make a certain sound called a heart murmur. Your doctor can hear a heart murmur with a stethoscope.
However, not all murmurs are signs of congenital heart defects. Many healthy children have heart murmurs.