Is coarctation of the aorta in pediatrics a risk diagnosis?
Authors:
J. Pavlíček 1,2; E. Klásková 3; S. Kaprálová 3; A. Palátová 3; E. Doležálková 4; A. Piegzová 4; R. Špaček 4; H. Wiedermannová 5; H. Burčková 5; T. Gruszka 1
Authors place of work:
Oddělení dětské a prenatální kardiologie, Klinika dětského lékařství FN a LF OU Ostrava
1; Centrum biomedicínského výzkumu, FN Hradec Králové
2; Dětská klinika FN a LF UP Olomouc
3; Gynekologicko-porodnická klinika FN a LF OU Ostrava
4; Oddělení neonatologie, FN a LF OU Ostrava
5
Published in the journal:
Čes-slov Pediat 2019; 74 (8): 458-464.
Category:
Original Papers
Summary
Objective: To study of the prevalence of coarctation of the aorta (COA), the date of its first symptoms occurrence in the pediatric population, and to determine the risk periods and assess the overall prognosis of the disease.
Methods: The retrospective cohort study monitoring the COA occurrence in the Moravian-Silesian Region was conducted between 1999–2018. Data from outpatient departments of pediatric cardiology were reviewed, together with genetic reports. In cases when the presence of COA was suspected prenatally, the birth of the pathological newborn was realized at a specialized centre, with following postnatal standardized examination performed by a pediatric cardiologist. Also, a pediatric cardiologist was present at all autopsies. Genetic testing was performed in indicated cases.
Results: During the monitored 20-year period, a total of 133 (0.57/1,000 cases of live birth) of COAs were observed in the total population of 232,300 children. In 23% (30/133), COA was a part of another complex heart defect. In the total of 103 cases (0.44/1000), COA was a major defect. COA was detected in 27% (28/103) prenatally, and in 73% (75/103) postnatally. In the postnatal period, the main symptom was murmur in 6% (27/75), critical symptomatology in 25% (19/75), dyspnoea in 12% (9/75), hypertension in 9% (7/75), and weakened pulsation of femoral arteries in 3% (2/75) of cases. Most frequently, COA was manifested in early newborns and infants in 32% (24/75) and 33% (25/75) of cases, respectively.
Conclusions: COA is a common, severe, and potentially critical VSV, with the risk of clinical manifestations at any stage of childhood. The rate of prenatal detection is low. In the postnatal period, COA was manifested in early neonates by critical symptomatology and in infants by heart murmur. Most findings require a surgical solution, which is usually associated with a very good prognosis.
Keywords:
coarctation of the aorta – congenital heart defect – screening – echocardiography – critical disease – murmur – hypertension
Zdroje
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Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
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