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- Cardiovascular Journal of Africa
- OA African Journal Archive
- Volume 5, Issue 2, 1994
Cardiovascular Journal of Africa - Volume 5, Issue 2, 1994
Volumes & issues
Volume 5, Issue 2, 1994
Source: Cardiovascular Journal of Africa 5, pp 50 –52 (1994)More Less
Electrocardiograms (ECGs) are routinely performed on children suspected of having a pericardial effusion. When the amplitude of the QRS-complexes is 'normal' in size the ECG is reported to be normal and the diagnosis is usually excluded. Twenty-six ECGs of patients with proven pericardial effusions were analysed by two paediatric cardiologists. Twenty-five of these ECGs were abnormal. Most of the abnormalities were nonspecific ST-segment and T-wave abnormalities, which were not diagnostic of pericardial effusions. Low-amplitude QRS complexes were only found in 11 of the 26 children; this gives a sensitivity of 42%. The ECG as a single diagnostic tool is therefore of little value in children with pericardial effusions but may help to differentiate between them and children with enlarged hearts.
Author I. Van Dyk, C.M. & TranficSource: Cardiovascular Journal of Africa 5, pp 54 –57 (1994)More Less
At Ga-Rankuwa Hospital, 50 paediatric patients received mechanical cardiac valve replacements for chronic rheumatic heart disease over a period of 4 years and 8 months. Twenty of 50 patients were lost to follow-up (40%). Thirty-three patients residing in the north and north-eastern Transvaal were identified and their referring hospitals visited. Sixty per cent of these patients (20/33) were not available at the peripheral hospital, and the hospital administration could not account for them.
Source: Cardiovascular Journal of Africa 5, pp 58 –61 (1994)More Less
The migration of a pacemaker from the subrectus area of the abdomen to the lower pelvic region, causing pacemaker electrode extension and eventual fracture in a child of 2 years, is reported. Subsequent analysis revealed that breakage may have been augmented by fibrous adhesion around the electrode at a site distal to the pacemaker rather than tension caused by the mass of the pacemaker alone.
Sudden cardiac death of a child caused by aberrant origin of left coronary artery from the right sinus of ValsalvaAuthor D.H. Levin, S.E. & KempSource: Cardiovascular Journal of Africa 5, pp 62 –64 (1994)More Less
This is a report on a child who, in the first decade of life, collapsed after effort and died suddenly. There was clinical evidence of acute myocardial ischaemia. At autopsy, a rare cause was found, viz. aberrant origin of the left coronary artery from the right sinus of Valsalva, which then coursed between the aorta and main pulmonary artery. The importance of recognising this congenital coronary artery abnormality is emphasised.
Author I.E. Adhikari, M. & HaffejeeSource: Cardiovascular Journal of Africa 5, pp 66 –68 (1994)More Less
Persistent pulmonary hypertension of the newborn (PPHN) may complicate severe respiratory failure in the neonate. The diagnosis of PPHN was made in 21 of 338 babies admitted to an intensive care unit over a 2-year period, i.e. 10,5 cases per year. Eleven were low-birth-weight (LBW) infants of whom 5 were small for gestational age. In those weighing over 2 500 g 3 were post-term and 5 small for gestational age. All the term babies had a history of fetal distress and 6 of the LBW infants had factors predisposing to asphyxia.
Source: Cardiovascular Journal of Africa 5, pp 70 –74 (1994)More Less
Results of the first 50 patients in South Africa in whom the Rashkind patent ductus arteriosus (PDA) occluder was placed within the ductus are presented. Patients weighing ? 8 kg with a diagnosis of a PDA ? 8 mm in diameter were eligible for inclusion into the study. Successful initial implantation of the device was achieved in 48 patients, with embolisation occurring in 2 patients. Both devices were successfully retrieved at surgery.
Author C.J. Knott-CraigSource: Cardiovascular Journal of Africa 5, pp 76 –81 (1994)More Less
Congenital heart surgery is one of the most precise forms of surgery practised today; the surgeon is required to confirm the diagnosis intra-operatively, reconstruct the heart three-dimensionally to attain an anatomically and functionally satisfactory repair, and complete this surgery within a very limited time. For the outcome to be successful, a dedicated and efficient team is required in which the cardiologist is expected to make an accurate pre-operative diagnosis, the anaesthesiologist and perfusionists are required to ensure that the myocardium, brain and other vital structures are adequately protected during surgery and that biochemical homeostasis and haemostasis are achieved at the end of the operation; the surgeon needs to effect an accurate repair, and the intensivist has to support the myocardium and manipulate the pulmonary and systemic vascular beds adequately to allow the heart to recover from the surgical intervention.
Source: Cardiovascular Journal of Africa 5, pp 83 –88 (1994)More Less
Major diagnostic and therapeutic advances in the management of infants and children with congenital heart disease (CHD) have taken place over the past few decades. These developments have had a profound effect on the survival patterns of affectedï¿½ children, with the result that a new patient community with unique medical, surgical and psychological problems has emerged. The present study revealed a population of 735 patients, now 15 years or older at Johannesburg Hospital, with congenital heart lesions. Sixty-two per cent of these patients are not fully compliant in terms of clinic attendance and this is a major cause for concern. This article reviews the population concerned and discusses its management, which should, ideally, be by a specialised multidisciplinary team.