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Arterial thoracic outlet syndrome in an adolescent. 一名青少年的胸廓出口动脉综合征。
IF 0.7 Q3 Medicine Pub Date : 2023-07-01 Epub Date: 2024-01-05 DOI: 10.4103/apc.apc_47_23
Shyam S Kothari, Bhavik Champaneri, Nirav Panchal

Arterial thoracic outlet syndrome (aTOS) is rarely diagnosed in children. A 15-year-old boy with recent-onset claudication was found to have aTOS on investigation. Bony abnormality other than the cervical rib might also cause aTOS. Enhanced awareness of aTOS as a cause of vascular symptoms in children is warranted.

动脉胸廓出口综合征(aTOS)很少在儿童中确诊。一名最近出现跛行的 15 岁男孩在接受检查时被发现患有 aTOS。除颈椎肋骨外,骨骼异常也可能导致胸廓出口综合征。因此,有必要加强对导致儿童血管症状的 aTOS 的认识。
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引用次数: 0
Intermittent obstruction of the left coronary artery ostia by a congenital supravalvular aortic membrane in an adult. 成人先天性主动脉瓣上膜间歇性阻塞左冠状动脉开口。
IF 0.7 Q3 Medicine Pub Date : 2023-07-01 Epub Date: 2024-01-05 DOI: 10.4103/apc.apc_25_23
Tanae El Ghali, Nadia Fellat, Nawal Doghmi, Mohamed Cherti

Left main coronary artery obstruction due to a congenital supra-aortic membrane is a rare anomaly, but it can have serious consequences, including significant myocardial ischemia that may result in impaired ventricular function or even sudden death. Therefore, early diagnosis and treatment of this condition are crucial for improving patient outcomes. We present, in this report, a patient with intermittent obstruction of the left coronary arteries caused by a congenital ostial membrane diagnosed in adulthood that resulted in myocardial ischemia.

先天性主动脉瓣上膜导致的左冠状动脉主干阻塞是一种罕见的异常现象,但它可能造成严重后果,包括心肌严重缺血,可能导致心室功能受损甚至猝死。因此,早期诊断和治疗对改善患者预后至关重要。在本报告中,我们介绍了一名在成年后被诊断出患有先天性骨膜引起的左冠状动脉间歇性阻塞并导致心肌缺血的患者。
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引用次数: 0
Left sided Scimitar syndrome. 左侧弯刀综合征
IF 0.7 Q3 Medicine Pub Date : 2023-07-01 Epub Date: 2024-01-05 DOI: 10.4103/apc.apc_73_23
Sabyasachi Pandey, Adaligere Paraswanath Bharath, Aditya P Mohata, Ashita Barthur, Anand P Subramanian, Mahimarangaiah Jayranganath

The images depict a rare case of Scimitar syndrome involving the left lower pulmonary vein.

图片描述的是一个罕见的涉及左下肺静脉的弯刀综合征病例。
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引用次数: 0
Changes in left ventricular systolic function after transcatheter patent ductus arteriosus closure in premature infants. 早产儿经导管动脉导管未闭后左心室收缩功能的变化。
IF 0.7 Q3 Medicine Pub Date : 2023-07-01 Epub Date: 2024-01-05 DOI: 10.4103/apc.apc_52_23
Aravinth Karunanandaa, Joseph Paolillo, Amanda Cook, Kamala Swayampakala, Matthew C Schwartz

Background: Changes in left ventricular (LV) systolic function have not been well described in premature neonates after transcatheter patent ductus arteriosus (PDA) closure.

Methods and results: We retrospectively identified all premature neonates < 3 kg who underwent a transcatheter PDA closure at our center between January 1 2015 and January 31, 2021. LV indices before and after closure were extracted and an analysis was performed. Overall, 23 neonates were included with a mean procedural weight of 1894 ± 622 g. At 24 h after closure, the median left ventricular ejection fraction (LVEF) (66% interquartile range [IQR] 12% vs. 61% IQR 12, P< 0.001) and median LV end-diastolic dimension z-score (3.3 IQR 1.8 vs. 1.4 IQR 2.6, P < 0.001) both decreased and 5 (22%) neonates had an LVEF <55%. Patients who had an LVEF <55% at 24 h had a higher preprocedure LV end-diastolic dimension z-score (4.2 IQR 1.2 vs. 2.8 IQR 1.6, P = 0.01), a higher preprocedure LV end-diastolic volume (19 mL IQR 4 mL vs. 11 mL IQR 11, P = 0.03), a higher birth weight (940 g IQR 100 g vs. 760 g IQR 140, P = 0.04), and were more likely to receive intravenous calcium during the procedure (60% vs. 11%, P = 0.04) compared to those with an LVEF ≥55% at 24 h after closure. Of those with LVEF <55% at 24 h, all normalized before discharge.

Conclusion: In preterm neonates who underwent successful transcatheter PDA closure, 23% developed abnormal LVEF after closure and those with significant LV dilation before the procedure were at increased risk for the development of LVEF <55% after closure.

背景:经导管动脉导管未闭(PDA)术后早产新生儿左心室(LV)收缩功能的变化尚未得到很好的描述:我们对 2015 年 1 月 1 日至 2021 年 1 月 31 日期间在本中心接受经导管动脉导管关闭术的所有体重小于 3 千克的早产新生儿进行了回顾性鉴定。我们提取了闭合前后的左心室指数并进行了分析。在闭合后 24 小时,中位左心室射血分数(LVEF)(66% 四分位间距 [IQR] 12% vs. 61% IQR 12,P< 0.001)和中位左心室舒张末期维度 z 评分(3.3 IQR 1.8 vs. 1.4 IQR 2.6,P< 0.001)均下降,5 名(22%)新生儿的 LVEF P = 0.01)、术前左心室舒张末期容积较高(19 mL IQR 4 mL vs. 11 mL IQR 11,P = 0.03)、出生体重较高(940 g IQR 100 g vs. 760 g IQR 140,P = 0.04),并且与关闭术后 24 小时 LVEF ≥55% 的新生儿相比,更有可能在术中静脉注射钙剂(60% vs. 11%,P = 0.04)。结论在成功进行经导管 PDA 关闭术的早产新生儿中,23% 的新生儿在关闭术后出现 LVEF 异常。
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引用次数: 0
Recurrent mycotic aneurysm of the aorta due to Rhizopus microsporus after cardiac surgery. 心脏手术后因小孢子根瘤菌而复发的主动脉霉菌性动脉瘤。
IF 0.7 Q3 Medicine Pub Date : 2023-07-01 Epub Date: 2024-01-05 DOI: 10.4103/apc.apc_46_23
Deepank Sahni, Saad Feroz, Mamdouh Al Ahmadi, Jocelyn Y Ang, Janet Poulik, Raya Safa
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引用次数: 0
Understanding the impact of clinical and leadership development activities for pediatric cardiac nurses in India. 了解临床和领导力发展活动对印度儿科心脏病护士的影响。
IF 0.7 Q3 Medicine Pub Date : 2023-05-01 Epub Date: 2023-09-08 DOI: 10.4103/apc.apc_83_23
Magdeline Aagard, Adriana Dobrzycka, Bistra Zheleva, Veeralakshmi Rajasekhar, Shubhitha Menon, Vaisakh Gopakumar

The major challenges for pediatric cardiac nursing in India include inadequacies in their levels of education and lack of recognition of their vital role in the health-care system. The aim of this study was to understand the impact of the leadership educational initiatives on pediatric cardiac nursing taken by Children's HeartLink and the Pediatric Cardiac Society of India. Semi-structured interviews were conducted with eight pediatric cardiac nurse leaders from different Indian hospitals. A review of interviews from a previous study and an extensive literature review provided further foundational data on two major themes. The first theme on nursing education focused on nursing curriculum update, continuing education, and leadership development. The second theme focused on improving the value of nursing in public perception, value in hospitals, and their career promotions. The study identified the potential targets for improvement and provided a nursing career development ladder applicable to India.

印度儿科心脏护理面临的主要挑战包括教育水平不足,以及对其在医疗保健系统中的重要作用缺乏认识。本研究的目的是了解儿童心脏链接和印度儿科心脏学会采取的领导力教育举措对儿科心脏护理的影响。对来自印度不同医院的八名儿科心脏科护士领导进行了半结构化访谈。对先前研究的访谈进行回顾和广泛的文献综述提供了关于两个主要主题的进一步基础数据。护理教育的第一个主题是护理课程更新、继续教育和领导力发展。第二个主题侧重于提高护理在公众认知中的价值、在医院的价值以及他们的职业晋升。该研究确定了潜在的改进目标,并提供了适用于印度的护理职业发展阶梯。
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引用次数: 0
Current career perspective of pediatric cardiologists in India. 当前印度儿科心脏病专家的职业前景。
IF 0.7 Q3 Medicine Pub Date : 2023-05-01 Epub Date: 2023-09-08 DOI: 10.4103/apc.apc_121_23
Sakshi Sachdeva, Bhargavi Dhulipudi

A survey was conducted to ascertain the current situation of early-mid-career pediatric cardiologists (<20 years of experience) practicing in India. A formatted questionnaire was sent as a Google Form through email and WhatsApp link. Out of 275 eligible participants, 138 responses were received. Two pediatric cardiologists independently analyzed the data and responses are presented. Results showed pediatric cardiology is not considered a lucrative career option by most of the surveyed Indian pediatric cardiologists. Urgent remedial measures are needed to maintain the recently found momentum in the field in the country.

进行了一项调查,以确定职业早期和中期儿科心脏病专家的现状(
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引用次数: 1
Clinical profile and outcomes of childhood dilated cardiomyopathy - A single-center three-decade experience. 儿童扩张型心肌病的临床概况和预后-单中心三十年的经验。
IF 0.7 Q3 Medicine Pub Date : 2023-05-01 Epub Date: 2023-09-08 DOI: 10.4103/apc.apc_149_22
Gousia Mukhtar, Bijulal Sasidharan, Kavassery Mahadevan Krishnamoorthy, Harikrishnan K N Kurup, Arun Gopalakrishnan, Deepa Sasikumar, Sankara Sarma, Ajit Kumar Valaparambil, Sivasankaran Sivasubramonian

Introduction and aims: Dilated cardiomyopathy (DCM) is an important cause of heart failure (HF) among children. Research on pediatric DCM remains surprisingly scarce. The primary objective of the study was to evaluate the clinical profile and outcomes of pediatric DCM and the secondary objective was to study the predictors of outcome.

Methods and results: We enrolled all patients with cardiomyopathy who presented to us between 1990 and 2020 and were younger than 18 years. During the 30-year study period, we identified 233 cases of pediatric cardiomyopathy. One hundred and nineteen (51%) cases had DCM. This retrospective cohort was analyzed to study their outcome and the possible predictors of outcome. Nearly, 8% presented in the neonatal period, and 37% in infancy. The most common mode of presentation was dyspnea on exertion (71%). Ninety-three patients presented in heart failure (78%). The median left ventricular dimension z-score in diastole was 4.3 (range 2.5-9.06). The median left ventricle (LV) ejection fraction was 31%. Seventy-two percent of this cohort were on angiotensin-converting-enzyme inhibitors, 40% on aldosterone antagonists, and 47% on beta-blockers. One-third had syndromic, metabolic, genetic, or any secondary cause identified. Twenty-seven patients satisfied the three-tiered clinical classification for the diagnosis of probable acute myocarditis. Over a mean follow-up of 3.29 years, 27% were lost to follow-up. Among the remaining patients who were on follow-up (n = 86), 39 (45%) died, 31 (36%) recovered, and 16 (18%) had persistent LV dysfunction. Heart Failure was the most common cause of death. Eight patients in this cohort (4.2%) had thromboembolic phenomena. Nine had sustained ventricular arrhythmias and six had atrial/junctional arrhythmias. Among the various risk factors studied, only infantile onset had a significant relationship with death or ventricular arrhythmias (P value- 0.05). The 5-year survival rate of DCM patients was 59%.

Conclusion: A reasonably good percentage of our population showed recovery of the left ventricular function (36%). Only infantile onset had a significant relationship with death or ventricular arrhythmias. The outcome in our DCM cohort is similar to other population cohorts.

引言和目的:扩张型心肌病(DCM)是儿童心力衰竭(HF)的重要原因。对小儿扩张型心肌病的研究仍然少得惊人。本研究的主要目的是评估儿童扩张型心肌病的临床特征和结果,次要目的是研究结果的预测因素。方法和结果:我们招募了1990年至2020年间出现在我们面前的所有年龄小于18岁的心肌病患者。在30年的研究期间,我们发现了233例儿童心肌病病例。一百一十九例(51%)患有扩张型心肌病。对这一回顾性队列进行分析,以研究其结果和可能的结果预测因素。近8%出现在新生儿期,37%出现在婴儿期。最常见的表现方式是运动时呼吸困难(71%)。93名患者出现心力衰竭(78%)。舒张期左心室尺寸z评分中位数为4.3(范围2.5-9.06),左心室射血分数中位数为31%。这一队列中72%的人服用血管紧张素转换酶抑制剂,40%的人服用醛固酮拮抗剂,47%的人服用β受体阻滞剂。三分之一的患者有综合征、代谢、遗传或任何次要原因。27名患者符合诊断可能急性心肌炎的三级临床分类。在3.29年的平均随访中,27%的患者失访。在其余接受随访的患者中(n=86),39人(45%)死亡,31人(36%)康复,16人(18%)存在持续性左心室功能障碍。心力衰竭是最常见的死亡原因。该队列中有8名患者(4.2%)出现血栓栓塞现象。9例为持续性室性心律失常,6例为心房/交界性心律失常。在所研究的各种危险因素中,只有婴儿发病与死亡或室性心律失常有显著关系(P值-0.05)。DCM患者的5年生存率为59%。结论:我们的人群中有相当好的比例显示左心室功能恢复(36%)。只有婴儿期发病与死亡或室性心律失常有显著关系。我们DCM队列的结果与其他人群队列相似。
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引用次数: 0
Partial anomalous venous connection with intrapulmonary dual drainage: Transcatheter treatment of a rare entity. 部分异常静脉连接伴肺内双重引流:经导管治疗的罕见病例。
IF 0.7 Q3 Medicine Pub Date : 2023-05-01 Epub Date: 2023-09-08 DOI: 10.4103/apc.apc_77_22
Varun Aggarwal, Alaa K Mohamed, Sameh M Said

Partial anomalous pulmonary venous return (PAPVR) is a rare congenital condition, and dual-drainage connection PAPVR to the left atrium has been reported in a few cases in the literature; in which cases, percutaneous catheterization was successfully used in lieu of surgery. We, hereby, describe a 7-month-old boy with a functional single-ventricle physiology with dual drainage of the left upper pulmonary vein to the left atrium and the innominate vein. Appropriate recognition of this entity allowed safe occlusion of the anomalous draining vein.

部分肺静脉回流异常(PAPVR)是一种罕见的先天性疾病,文献中有少数病例报道了PAPVR与左心房的双引流连接;在这些病例中,经皮导管插入术成功地代替了手术。我们在此描述一名7个月大的男孩,他具有功能性单心室生理学,左上肺静脉至左心房和无名静脉双重引流。对该实体的适当识别使异常引流静脉得以安全闭塞。
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引用次数: 0
The utility of speckle-tracking echocardiography in early and midterm follow-up after anomalous origin of the left coronary artery from the pulmonary artery repair. 斑点跟踪超声心动图在肺动脉修复后左冠状动脉异常起源地的早期和中期随访中的应用。
IF 0.7 Q3 Medicine Pub Date : 2023-05-01 Epub Date: 2023-09-08 DOI: 10.4103/apc.apc_10_23
Mani Ram Krishna, Kaushik Jothinath, Vijay Kumar Raju

Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a reversible cause of left ventricular (LV) dysfunction in infants. The LV function is expected to improve serially and return to normal by 1 year after surgical repair. The pattern of improvement in LV function has not been serially analyzed after ALCAPA repair. We report our preliminary experience with serial assessment of LV function in infants undergoing ALCAPA repair utilizing speckle tracking echocardiography.

来自肺动脉的异常左冠状动脉(ALCAPA)是婴儿左心室(LV)功能障碍的可逆原因。左心室功能有望连续改善,并在手术修复后1年内恢复正常。ALCAPA修复后左心室功能改善的模式尚未得到连续分析。我们报告了利用斑点追踪超声心动图对接受ALCAPA修复的婴儿左心室功能进行系列评估的初步经验。
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引用次数: 0
期刊
Annals of Pediatric Cardiology
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