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Effects of captopril on the distribution of left ventricular output with ventricular septal defect buy discount silvitra 120mg line. Captopril in infants for congestive heart failure secondary to a large ventricular left-to-right shunt silvitra 120mg generic. Update on pharmacological heart failure therapies in children: Do adult medications work in children and if not order silvitra 120mg on line, why not? Lessons learned from a pediatric clinical trial: the Pediatric Heart Network angiotensin-converting enzyme inhibition in mitral regurgitation study discount 120mg silvitra free shipping. Comparison of neuroendocrine activation in patients with left ventricular dysfunction with and without congestive heart failure. Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure. Loop diuretic resistance in heart failure: resistance etiology-based strategies to restoring diuretic efficacy. Effects of the angiotensin converting enzyme inhibitor enalapril on the long-term progression of left ventricular dysfunction in patients with heart failure. Effects of the angiotensin converting enzyme inhibitor enalapril on the long-term progression of left ventricular dilatation in patients with asymptomatic systolic dysfunction. Comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure. A randomized trial of the angiotensin- receptor blocker valsartan in chronic heart failure. Acute hemodynamic effects of captopril in children with a congestive or restrictive cardiomyopathy. Hemodynamic effects of a single oral dose of enalapril among children with asymptomatic chronic mitral regurgitation. Enalapril in infants with single ventricle: results of a multicenter randomized trial. Long-term enalapril therapy for left ventricular dysfunction in doxorubicin-treated survivors of childhood cancer. Enalapril to prevent cardiac function decline in long-term survivors of pediatric cancer exposed to anthracyclines. Effect of perindopril on the onset and progression of left ventricular dysfunction in Duchenne muscular dystrophy. Effects of angiotensin-converting enzyme inhibitors and/or beta blockers on the cardiomyopathy in Duchenne muscular dystrophy. Effects of steroids and angiotensin converting enzyme inhibition on circumferential strain in boys with Duchenne muscular dystrophy: a cross-sectional and longitudinal study utilizing cardiovascular magnetic resonance. Cough in pediatric patients receiving angiotensin-converting enzyme inhibitor therapy or angiotensin receptor blocker therapy in randomized controlled trials. Efficacy and safety of the Angiotensin receptor blocker valsartan in children with hypertension aged 1 to 5 years. Candesartan cilexetil in children with hypertension or proteinuria: preliminary data. Therapy of idiopathic dilated cardiomyopathy with chronic beta- adrenergic blockade. Effect of beta-adrenergic blockade on myocardial function and energetics in congestive heart failure. Improvements in hemodynamic, contractile, and diastolic performance with bucindolol. Carvedilol produces dose-related improvements in left ventricular function and survival in subjects with chronic heart failure. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. Rationale for treatment of patients with chronic heart failure with adrenergic blockade. Decreased catecholamine sensitivity and beta-adrenergic- receptor density in failing human hearts. Comparative hemodynamic, left ventricular functional, and antiadrenergic effects of chronic treatment with metoprolol versus carvedilol in the failing heart. Effect of metoprolol on myocardial function and energetics in patients with nonischemic dilated cardiomyopathy: a randomized, double-blind, placebo-controlled study. Meta-analysis: beta-blocker dose, heart rate reduction, and death in patients with heart failure. Delisting of infants and children from the heart transplantation waiting list after carvedilol treatment. Prospective single-arm protocol of carvedilol in children with ventricular dysfunction. Role of aldosterone blockade for treatment of heart failure and post- acute myocardial infarction. Aldosterone, mineralocorticoid receptor activation, and cardiovascular remodeling. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. Impact of spironolactone on endothelial function in patients with single ventricle heart. The efficacy and safety of the novel aldosterone antagonist eplerenone in children with hypertension: a randomized, double-blind, dose-response study. Renin-angiotensin-aldosterone genotype influences ventricular remodeling in infants with single ventricle. The cardiovascular effects of eplerenone, a selective aldosterone-receptor antagonist. Digoxin: clinical highlights: a review of digoxin and its use in contemporary medicine. Withdrawal of digoxin from patients with chronic heart failure treated with angiotensin-converting-enzyme inhibitors. Association of serum digoxin concentration and outcomes in patients with heart failure. Relationship of serum digoxin concentration to mortality and morbidity in women in the digitalis investigation group trial: a retrospective analysis. Short-term intravenous milrinone for acute exacerbation of chronic heart failure: a randomized controlled trial. Outpatient continuous inotrope infusion as an adjunct to heart failure therapy in Duchenne muscular dystrophy. Outpatient continuous parenteral inotropic therapy as bridge to transplantation in children with advanced heart failure. Neutral endopeptidase inhibition and the natriuretic peptide system: an evolving strategy in cardiovascular therapeutics. Serelaxin: a novel therapy for acute heart failure with a range of hemodynamic and non- hemodynamic actions. A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. A randomized study of the prevention of sudden death in patients with coronary artery disease. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. Incidence of and risk factors for sudden cardiac death in children with dilated cardiomyopathy: a report from the Pediatric Cardiomyopathy Registry. Results of a multicenter retrospective implantable cardioverter-defibrillator registry of pediatric and congenital heart disease patients. Implantable cardioverter-defibrillator lead failure in children and young adults: a matter of lead diameter or lead design? Prevention of sudden cardiac death with implantable cardioverter-defibrillators in children and adolescents with hypertrophic cardiomyopathy.
Long-term survival and valve-related complications in young women with cardiac valve replacements purchase silvitra 120 mg fast delivery. Influence of pregnancy after bioprosthetic valve replacement in young women: a prospective five-year study purchase silvitra 120mg free shipping. Outcome of pregnancy in women after pulmonary autograft valve replacement for congenital aortic valve disease buy silvitra 120mg visa. Anticoagulation of pregnant women with mechanical heart valves: a systematic review of the literature generic 120 mg silvitra visa. Use of low molecular weight heparin in pregnant women with mechanical heart valves. Maternal complications and pregnancy outcome in women with mechanical prosthetic heart valves treated with enoxaparin. Management of pregnant women with mechanical heart valve prosthesis: thromboprophylaxis with low molecular weight heparin. Use of high intensity adjusted dose low molecular weight heparin in women with mechanical heart valves during pregnancy: a single-center experience. Dose-dependent fetal complications of warfarin in pregnant women with mechanical heart valves. Mitral mechanical replacement in young rheumatic women: analysis of long-term survival, valve-related complications, and pregnancy outcomes over a 3707- patient-year follow-up. Recurrence risks in offspring of adults with major heart defects: results from first cohort of British collaborative study. Maternal transmission of congenital heart diseases: new recurrence risk figures and the questions of cytoplasmic inheritance and vulnerability to teratogens. A second-generation study of 427 probands with congenital heart defects and their 837 children. Reduction of urinary tract and cardiovascular defects by periconceptional multivitamin supplementation. Incremental diagnostic yield of pediatric cardiac assessment after fetal echocardiography in the offspring of women with congenital heart disease: a prospective study. Canadian Cardiovascular Society 2009 Consensus Conference on the management of adults with congenital heart disease: executive summary. Canadian Cardiovascular Society 2009 Consensus Conference on the management of adults with congenital heart disease: introduction. Canadian Cardiovascular Society 2009 Consensus Conference on the management of adults with congenital heart disease: shunt lesions. Canadian Cardiovascular Society 2009 Consensus Conference on the management of adults with congenital heart disease: complex congenital cardiac lesions. Canadian Cardiovascular Society position statement on the management of thoracic aortic disease. A review of the current use of magnetic resonance imaging in pregnancy and safety implications for the fetus. Pregnancy in women with heart disease: risk assessment and management of heart failure. Recurrence rates of arrhythmias during pregnancy in women with previous tachyarrhythmia and impact on fetal and neonatal outcomes. Effects of amiodarone administration during pregnancy on neonatal thyroid function and subsequent neurodevelopment. Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. The American Heart Association in collaboration with the International Liaison Committee on Resuscitation. Venous thromboembolism, thrombophilia, antithrombotic therapy, and pregnancy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Outcome of cardiovascular surgery and pregnancy: a systematic review of the period 1984–1996. Anesthetic management of a consecutive cohort of women with heart disease for labor and delivery. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Choosing the best contraceptive method for the adult with congenital heart disease. Chest pain accounts for 650,000 physician visits per year in patients 10 to 21 years of age (4). Awareness of both cardiovascular disease and the risk of sudden cardiac death have increased both in media and in national education programs. As a result, greater than 50% of adolescents with a history of chest pain report significant fear of cardiac disease (5). The mean age of children and adolescents who complain of chest pain is 11 to 14 years, but chest pain can occur in children as young as 4 years of age (1,6). Chest pain is equally as common in males and females, although certain causes of pain may have a sex-specific predilection. The relative frequencies of types of chest pain have been reported by several investigators and are summarized in Table 70. The most common source of chest pain in children and adolescents is the musculoskeletal structures of the chest wall (1,2,4,5,6,7,8,9). Cause of Pain (1) (2) (3) (5) (6) (8) (9) (10) (11) Idiopathic 45 28 12 46 21 55 13 52 Musculoskeletal 10 15 28 13 15 16 36 Costochondritis 23 10 16 9 2 9 Pulmonary 12 12 19 21 3 31 64 7 Psychogenic 5 9 9 1 Trauma 4 15 3 9 7 Hyperventilation 23 Cardiac disease 3 1 1 4 6 4 1 Gastrointestinal 7 3 4 2 3 3 Sickle cell disease 2 3 Breast related 6 Miscellaneous 10 21 20 2 9 31 6 Musculoskeletal/Chest-Wall Pain Costochondritis Costochondritis is a common cause of musculoskeletal chest-wall pain, particularly in adolescent patients (12). The onset of the pain may be preceded by a respiratory illness, although the exact etiology is unknown. The pain typically involves two to four contiguous costochondral or costosternal junctions, between the second and fifth costal cartilages (1,12). The pain is most commonly unilateral, and may affect the left side more frequently than the right. The patient will complain of a sharp pain lasting from several seconds to several minutes, which is exacerbated by deep breathing. The patient may describe a “burning” sensation for a few minutes after deep palpation. It is important to apply sufficient pressure during this palpation, as light touch may not reproduce the pain. A firm “rocking” motion just lateral to the sternum may be effective in eliciting this pain. Treatment consists of reassurance, rest from athletic or strenuous activities and occasionally may require the use of nonsteroidal anti-inflammatory medications at least in the acute phase. Tietze Syndrome Tietze syndrome involves the inflammation of a single costochondral junction (14). While this syndrome has been reported in children and even infants, it remains relatively uncommon in childhood (14). The affected joint will be swollen and tender to palpation, and may be warm to the touch. The pain typically is self- limited, lasting anywhere from a few weeks to a few months. Idiopathic Chest-Wall Pain Nonspecific (idiopathic) chest-wall pain is the most common type of chest pain in children and adolescents (see Table 70. The pain often is exacerbated by deep breathing, and may occur during exercise or while at rest. Sometimes, squeezing the chest cage or gently pressing on the sternum can reproduce the pain. More frequently, the pain cannot be reproduced by palpating or pushing on the chest, but the costochondral and costosternal joints are not tender. There are no associated symptoms, but patients may feel anxious while experiencing the pain (15). Children with idiopathic chest pain tend to have longer courses than children with other etiologies, and may have intermittent chest pain for many months (1,6,16). A thoughtful explanation of the cause and benign nature of the pain frequently is enough to reassure the patient with idiopathic chest-wall pain. Precordial Catch Syndrome Precordial catch syndrome is a brief (several seconds), sharp, stabbing pain occurring in healthy children, most commonly in patients between 6 and 12 years of age (17). The pain typically is located below the left breast or at the lower left sternal border (17,18). The pain can be so sharp that the patient will breathe shallowly for several seconds.
Maternal chronic illness buy 120 mg silvitra overnight delivery, immunizations generic silvitra 120mg mastercard, medications purchase 120mg silvitra, and nutrition appear to be the targets with greatest potential impact buy generic silvitra 120mg, in terms of preventing not only congenital heart defects but also many other adverse fetal and maternal outcomes. Because of how early the embryonic heart develops, the cornerstone of prevention is preconception care—an integrated set of interventions aimed at lifelong health promotion and addressing multiple risk factors. Implementing these interventions effectively will require not only individual education and clinical interventions, but also long-term, population-based approaches that address the deeper social and economic determinants of health. The challenges are many: However, the evidence is available and the benefits can be considerable, in terms of health, wealth, and lives. Noninherited risk factors and congenital cardiovascular defects: current knowledge: a scientific statement from the American Heart Association Council on Cardiovascular Disease in the Young: endorsed by the American Academy of Pediatrics. Congenital Heart Disease: Molecular Genetics, Principles of Diagnosis and Treatment. Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. March Of Dimes Global Report On Birth Defects: The Hidden Toll Of Dying And Disabled Children. Congenital heart defects in Europe: prevalence and perinatal mortality, 2000 to 2005. Lifetime prevalence of congenital heart disease in the general population from 2000 to 2010. Genetic and environmental risk factors of major congenital heart disease: the Baltimore-Washington Infant Study 1981–1989. Epidemiology of congenital heart disease: the Baltimore- Washington Infant Study 1981–1989. Prenatal detection of heart defects in a non-selected population of 30,149 fetuses—detection rates and outcome. Incidence and natural course of trabecular ventricular septal defect: two-dimensional echocardiography and color Doppler flow imaging study. Prevalence of congenital heart disease assessed by echocardiography in 2067 consecutive newborns. Congenital heart defect case ascertainment by the Alberta Congenital Anomalies Surveillance System. Significance of cardiac defects in the developing fetus: a study of spontaneous abortuses. Congenital heart disease among spontaneous abortuses and stillborn fetuses: prevalence and associations. Termination of pregnancy for fetal anomaly after 23 weeks of gestation: a European register-based study. Selected birth defects data from population-based birth defects surveillance programs in the United States, 2003–2007. Boy:girl ratio in children born with different forms of cardiac malformation: a population- based study. Racial/Ethnic disparities in risk of early childhood mortality among children with congenital heart defects. The prevalence of adult congenital heart disease, results from a systematic review and evidence based calculation. Congenital heart disease in the general population: changing prevalence and age distribution. Hospital Stays, Hospital Charges, and In-Hospital Deaths Among Infants with Selected Birth Defects – United States, 2003. Prioritization of comparative effectiveness research topics in hospital pediatrics. Excess costs associated with complications and prolonged length of stay after congenital heart surgery. Inpatient health care use among adult survivors of chronic childhood illnesses in the United States. Measuring the global burden of disease and epidemiological transitions: 2002– 2030. Infant mortality and congenital anomalies from 1950 to 1994: an international perspective. Racial differences by gestational age in neonatal deaths attributable to congenital heart defects — United States, 2003–2006. Mortality associated with congenital heart defects in the United States: trends and racial disparities, 1979–1997. Mortality resulting from congenital heart disease among children and adults in the United States, 1999 to 2006. Quality-of-life and congenital heart defects: comparing parent and professional values. Brain abnormalities and neurodevelopmental delay in congenital heart disease: systematic review and meta-analysis. Long-term and developmental outcomes of children with complex congenital heart disease. Outcomes regarding the central nervous system in children with complex congenital cardiac malformations. Educational achievement among long-term survivors of congenital heart defects: a Danish population-based follow-up study. Impact of congenital heart disease on brain development and neurodevelopmental outcome. Executive function and theory of mind in school-aged children after neonatal corrective cardiac surgery for transposition of the great arteries. Long-term outcome of speech and language in children after corrective surgery for cyanotic or acyanotic cardiac defects in infancy. Predictors of impaired neurodevelopmental outcomes at one year of age after infant cardiac surgery. Neurodevelopmental status of newborns and infants with congenital heart defects before and after open heart surgery. Brain volume and metabolism in fetuses with congenital heart disease: evaluation with quantitative magnetic resonance imaging and spectroscopy. Neurodevelopmental outcomes after congenital heart surgery and strategies for improvement. Neurodevelopmental outcomes in infants after surgery for congenital heart disease: a comparison of single-ventricle vs. Patient characteristics are important determinants of neurodevelopmental outcome at one year of age after neonatal and infant cardiac surgery. Factors associated with adverse neurodevelopmental outcomes in infants with congenital heart disease. Relationship of surgical approach to neurodevelopmental outcomes in hypoplastic left heart syndrome. Psychological adjustment and quality of life in children and adolescents following open-heart surgery for congenital heart disease: a systematic review. Occurrence and predictors of developmental impairments in 3-year-old children with congenital heart defects. Longitudinal analysis of emotional problems in children with congenital heart defects: a follow-up from age 6 to 36 months. Quality of life of adult congenital heart disease patients: a systematic review of the literature. Relationship of patient and medical characteristics to health status in children and adolescents after the Fontan procedure. The impact of the severity of disease and social disadvantage on quality of life in families with congenital cardiac disease. Is the severity of congenital heart disease associated with the quality of life and perceived health of adult patients? Late results and quality of life after pediatric cardiac surgery in Finland: a population-based study of 6,461 patients with follow-up extending up to 45 years. Health-related Quality of Life in children and adolescents after invasive treatment for congenital heart disease. Quality of life in children with heart disease as perceived by children and parents. Health status, functional abilities, and quality of life after the Mustard or Senning operation.
These observations have saved many children undergoing congenital heart operations because the surgeon buy cheap silvitra 120mg on line, now aware of Dr generic 120mg silvitra with amex. His “Andersonian” terminology is very logical and clarifies much of what we see daily purchase silvitra 120mg amex. His wife generic 120 mg silvitra fast delivery, Christine, accompanies him on his various trips and is an excellent teacher herself. The Surgeons Ludwig Rehn (1849–1930) was the first surgeon to operate on the heart. Although many years earlier, the Aztecs had perfected cardiectomy, the first heart operation with intent toward saving lives was not done until 1896. He was an excellent observor; a year earlier he had shown that a chemical caused bladder cancer in aniline dye workers. He described a heart operation that he did in a 22 year old who had been stabbed during an altercation in a park the night before. After unsuccessful treatment with rest, icebags, and camphor injection, he began to deteriorate. Proving them wrong, by 1907 he had collected 124 cases of “heart suture” with 60% mortality (vs. Gross (1905–1988) first planned upon becoming a surgical pathologist and trained for 3 years at the Peter Bent Brigham, then went to Harvard for surgical training. At the age of 33 years, while a surgical chief resident on August 26, 1938, he waited until his chief, Dr. William Ladd, was out of town (but had permission from the acting chief), and operated a 7-year-old girl who had a 7-mm patent arterial duct, closing it with a single no. Ladd had no choice but to rehire him under political pressure and against his own wishes. Taussig visited him in the late 1930s and tried to convince him to try the shunt concept that she had developed, he said “Madam, I close ductuses, I do not make new ductuses”. Gross had many honors throughout his career, including being the first president of the American Pediatric Surgical Association and recipient of two Lasker Awards. Clarence Crawfoord (1899–1984) was at the Karolinska institute, Stockholm, Sweden. Crawfoord had done two successful pulmonary embolectomies, and in the 30s he introduced the concept of heparin prophylaxis for pulmonary emboli. He did successful pneumonectomies after he pioneered positive pressure mechanical ventilation in the 40s. Ake Senning did the first atrial switch operation for transposition and he implanted the first pacemaker. He was a talented violinist and did professional training at the Stockholm Musical Academy. He did an internship in urology but his assistant residency in general surgery was not renewed. Part of their work was to create a pulmonary hypertension model that was abandoned because pulmonary hypertension did not result from the subclavian swingdown done in the dogs. He became chief of surgery at Johns Hopkins in 1941 (after several bouts of tuberculosis) and brought Mr. Helen Taussig, he created a ductus-like situation using the previous pulmonary hypertension dog concept—subclavian artery swingdown. Thomas standing over his shoulder and guiding most of the operation, the tetralogy patient survived and became a “lovely colour” (Dr. In 1948 he developed a dilator to open stenotic pulmonary valves in patients with pulmonary stenosis and tetralogy patients. He did many mitral finger fracture valvotomies for rheumatic patients with mitral valve stenosis, a technique first developed by Dr. Henry Souttar in 1925, but Souttar was so roundly criticized by his colleagues that he abandoned the technique (31). Blalock spent time with him and their collaboration continued to the point that Brock developed a bypass pump and used hypothermia, bringing the open heart technique to England. He was known as an exacting person who did not tolerate laziness or unclear thinking. He was knighted in 1954 and received several awards for his expertise and contributions. He completed his degree at Johns Hopkins, interned there, and worked with Blalock whom he assisted along with Longmire on the first Blalock–Thomas–Taussig shunt. His training was interrupted by a stint in the Army Medical Corps where he was Chief of surgical services in Linz, Austria. He came back to Hopkins and finished training and remained as an instructor in surgery. He says that the main reason he was hired by Blalock was to “keep those damn women out of my hair”—Drs. Taussig, Wittemore, Hanson, and Engle made evening rounds on postoperative patients and were calling Dr. Cooley worked with Sir Russell Brock in 1950, then returned to Houston in 1951 where he worked with Dr. He resigned from Baylor in 1969 after a disagreement with DeBakey over use of a left ventricular assist device. He did the first artificial heart implant in a patient who survived 65 hours; he used it subsequently as a bridge. He is a family man with five daughters and several grandchildren and great grandchildren. John Gibbon (1903–1973) was very frustrated as a resident in 1930 after having spent the entire night with a girl who was dying of a pulmonary embolus. Of note, pulmonary embolectomy was the driving force in most of the early bypass approaches. After 20 years of trial and error, Gibbon developed the first heart–lung machine and used it to close an atrial septal defect in 1953 (34,35). Five of his other open heart patients died and he became so discouraged that he called for a moratorium on all open heart surgery. The four others had less than standard anesthesia and were moribund by their time on the pump. His problems were not related to the pump; instead they were a combination of inaccurate diagnosis, problems with anesthesia, and poor support from cardiac pathology. Nonetheless, his pioneering work provided the pump that was the prototype subsequently and successfully used by Dr. Lest we forget the past, a device had been developed in 1885 to perfuse organs (36,37). A bubble oxygenator had been developed by Brukhonenko in the late 1930s (38) but the work was not recognized during the Soviet purges. It is also interesting to note that a glass prototype of the pump was developed in 1935 by Dr. His sister-in-law had heart disease and he thought that surgery should be possible. He started the project in the early 1930s and worked with Carel (French surgeon) on a glass device that successfully perfused organs. They described an artificial heart in a book—“The Culture of Organs” (40) but never built it. Hitler was a friend who kept the press away from Lindbergh—he sat in his box at the 1936 world Olympic Games (41). The first atrial septal defect closure had been done there by two of his colleagues, Drs. They, through experiments on dogs, felt that deep hypothermia (28°C) and inflow occlusion would allow visualization and closure of a secundum atrial defect (34). Over the next year 45 cross-circulation cases were done—ventricular septal defect, tetralogy of Fallot, atrioventricular septal defect, and pulmonary valve steosis—with an overall 33% mortality (42,43). Kirklin the next day on a 1954 trip to the congenital heart surgery centers in Minnesota. The night before surgery, Walt took them to a steak house, had a double martini before and again after dinner, danced with the waitresses, and operated the next morning while apparently hung over. Lillehei looked at problems as those that should be solved, not as a roadblock or a reason to quit.