|
| ||
|
|
||
Cardiac Problems (cardiac + problem)
Selected AbstractsAn Assessment of the Ability of Diplomates, Practitioners, and Students to Describe and Interpret Recordings of Heart Murmurs and ArrhythmiaJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 6 2001Jonathan M. Naylor The ability of clinicians, ie, 10 veterinary students, 10 general practitioners, and 10 board certified internists, to describe and interpret common normal and abnormal heart sounds was assessed. Recordings of heart sounds from 7 horses with a variety of normal and abnormal rhythms, heart sounds, and murmurs were analyzed by digital sonography. The perception of the presence or absence of the heart sounds S1, S2, and S4 was similar for clinicians irrespective of their level of training and was in agreement with the sonographic interpretation on 89, 82, and 78% of occasions, respectively. However, practitioners were less likely to correctly describe the presence of S3. The heart rhythm was correctly described as being regular or irregular on 89% of occasions, and this outcome was not affected by level of training. Differentiation of the type of irregularity was less reliable. The perception of the intensity of a heart murmur was accurate and correlated with the grade assigned in the living horses, R2= .68, and with sonographic measurements of the murmur's intensity, R2= .69. Clinicians overestimated the duration of cardiac murmurs, particularly that of the loud systolic murmur. Only diplomates could reliably differentiate systolic from diastolic murmurs. The ability to diagnose the underlying cardiac problem was significantly affected by training; diplomates, practitioners, and undergraduates made the correct diagnosis on 53, 33, and 29% of occasions, respectively. The poor diagnostic ability of practitioners and the lack of improvement in diagnostic skill after the 2nd year of veterinary school emphasizes the need for better teaching of these skills. Digital sonograms that combine sound files with synchronous visual interpretations may be useful in this regard. [source] Down syndrome: a cardiovascular perspectiveJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 5 2009J. C. Vis Abstract This review focuses on the heart and vascular system in patients with Down syndrome. A clear knowledge on the wide spectrum of various abnormalities associated with this syndrome is essential for skilful management of cardiac problems in patients with Down syndrome. Epidemiology of congenital heart defects, cardiovascular aspects and thyroid-related cardiac impairment in patients with Down syndrome will be discussed. [source] Cardiac morbidity and mortality related to orthotopic liver transplantationLIVER TRANSPLANTATION, Issue 12 2004George Therapondos This article briefly discusses the cardiac status of liver transplant recipients and their preoperative cardiac evaluation. It describes in detail perioperative and early and late postoperative complications as well as the cardiac problems associated with immunosuppression. The preoperative cardiovascular status of patients is important in determining how they cope with the stresses imposed by liver transplantation. Minor early cardiac events are common and may influence longer term cardiac morbidity. Immunosuppressive therapy may have short term effects but is likely to adversely affect long term cardiac risk. (Liver Transpl 2004;10:1441,1453.) [source] Natural history and long-term outcome of cardiac rhabdomyomas detected prenatallyPRENATAL DIAGNOSIS, Issue 4 2004Vlasta Fesslova Abstract Objectives To analyse the data of fetal cases with rhabdomyomatosis, the growth of masses in utero, and the relative outcome. Material and Methods Thirteen cases of cardiac/pericardial tumours with characteristics suggesting rhabdomyomatosis were found in our centre on fetal echocardiography, five before 24 wg (group A) and eight (group B) at 25 to 36 wg. Four patients terminated the pregnancy, nine continued the pregnancy and were followed-up until delivery and after birth (median postnatal follow-up of 4.2 years, range 18 months,16 years). Results In six/nine cases that continued the pregnancy (66.7%), the growth of smaller tumor masses was proportional with gestational age until 30 to 32 wg and was stable after that. In three cases, larger masses grew disproportionally and other small masses were revealed, causing a partial obstruction of outflow tracts. After birth, no case required surgery and no serious rhythm problems occurred. Cardiac masses regressed at least partially in all cases. Tuberous sclerosis was diagnosed in 9/11 cases (81.1%) investigated by magnetic resonance imaging in utero or postnatally. One case also had bilateral polycystic kidneys. Conclusions Multiple and larger noduli progressed disproportionally in utero, until 30 to 36 wg. No relevant cardiac problems occurred after birth and the masses regressed in all cases. The high frequency of association with tuberous sclerosis is confirmed in our series. Copyright © 2004 John Wiley & Sons, Ltd. [source] Covert fears and anxiety in asthma and congenital heart disease,CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2001S Gupta Summary Aim To compare anxiety, fears and behavioural problems in children with asthma and children with congenital heart disease, and with the normative population. To also review the influence of maternal anxiety, time since diagnosis and severity of disease. Design Children administered Fear Survey Scale (FSSC-R) and Child Manifest Anxiety Scale (R-CMAS). Mothers given Child Behaviour Checklist (CBCL) and State Trait Anxiety Scale (STAI-S and STAI-T). Normative means and SDs compared with means and SDs for both medical groups. The mother's scores on the STAI-S and STAI-T scales were correlated with the child's scores on the FSSC-R and the R-CMAS. Setting Outpatient Asthma and Cardiology multidisciplinary Clinics at a tertiary care paediatric facility, Alberta Children's Hospital. Subjects: Forty children with asthma (aged 6,17 years) were compared with 39 children with congenital heart disease. Intake questionnaires and interviews determined these children to be without obvious psycho-social problems. Results Children with asthma and children with congenital heart disease had more medical fears, and more physiological anxiety than normative samples. Increased maternal anxiety was correlated in both groups with increased child anxiety, medical fears and behavioural problems in the child. Similarly, increased severity of asthma or cardiac problems was associated with more physiological anxiety and more fears. Less time since diagnosis of the disease adversely affected social interactions in both groups of children. Conclusion Physiological anxiety, medical fears and maternal anxiety are important issues requiring attention in asthma and cardiac disease, even in the absence of obvious psychosocial problems. There may be specific problems with a recent diagnosis of a chronic illness. [source] | ||||||||||