Coarctation of the aorta(CoA)is a relatively common congenital cardiac defect often causing few symptoms and therefore can be challenging to diagnose.The hallmark finding on physical examination is upper extremity hyp...Coarctation of the aorta(CoA)is a relatively common congenital cardiac defect often causing few symptoms and therefore can be challenging to diagnose.The hallmark finding on physical examination is upper extremity hypertension,and for this reason,CoA should be considered in any young hypertensive patient,justifying measurement of lower extremity blood pressure at least once in these individuals.The presence of a significant pressure gradient between the arms and legs is highly suggestive of the diagnosis.Early diagnosis and treatment are important as long-term data consistently demonstrate that patients with CoA have a reduced life expectancy and increased risk of cardiovascular complications.Surgical repair has traditionally been the mainstay of therapy for correction,although advances in endovascular technology with covered stents or stent grafts permit nonsurgical approaches for the management of older children and adults with native CoA and complications.Persistent hypertension and vascular dysfunction can lead to an increased risk of coronary disease,which,remains the greatest cause of long-term mortality.Thus,blood pressure control and periodic reassessment with transthoracic echocardiography and threedimensional imaging(computed tomography or cardiac magnetic resonance)for should be performed regularly as cardiovascular complications may occur decades after the intervention.展开更多
Background:There is limited literature written on the course and outcomes for pregnant mothers with Shone complex.Methods:We describe a case series of five pregnancies in four women with Shone complex within a multidi...Background:There is limited literature written on the course and outcomes for pregnant mothers with Shone complex.Methods:We describe a case series of five pregnancies in four women with Shone complex within a multidisciplinary cardio-obstetrics clinic from 2016–2018.Results:Maternal age ranged from 21–39 years.Three patients had preserved left ventricular function while one had moderately decreased function.Gestational age at presentation ranged from 6–15 weeks.There were three successful pregnancies(mean gestational age=37 weeks,range 35–39 weeks)with one patient accounting for two unsuccessful pregnancies.All infants were delivered via Cesarean section.One infant required a NICU stay,but all other infants delivered were healthy.Conclusion:Patients with Shone complex can have successful pregnancies although complications can occur for both the mother and the baby.Comprehensive prenatal care,coordinated and consistent management during pregnancy,and tertiary care support can promote positive maternal and fetal outcomes.展开更多
文摘Coarctation of the aorta(CoA)is a relatively common congenital cardiac defect often causing few symptoms and therefore can be challenging to diagnose.The hallmark finding on physical examination is upper extremity hypertension,and for this reason,CoA should be considered in any young hypertensive patient,justifying measurement of lower extremity blood pressure at least once in these individuals.The presence of a significant pressure gradient between the arms and legs is highly suggestive of the diagnosis.Early diagnosis and treatment are important as long-term data consistently demonstrate that patients with CoA have a reduced life expectancy and increased risk of cardiovascular complications.Surgical repair has traditionally been the mainstay of therapy for correction,although advances in endovascular technology with covered stents or stent grafts permit nonsurgical approaches for the management of older children and adults with native CoA and complications.Persistent hypertension and vascular dysfunction can lead to an increased risk of coronary disease,which,remains the greatest cause of long-term mortality.Thus,blood pressure control and periodic reassessment with transthoracic echocardiography and threedimensional imaging(computed tomography or cardiac magnetic resonance)for should be performed regularly as cardiovascular complications may occur decades after the intervention.
文摘Background:There is limited literature written on the course and outcomes for pregnant mothers with Shone complex.Methods:We describe a case series of five pregnancies in four women with Shone complex within a multidisciplinary cardio-obstetrics clinic from 2016–2018.Results:Maternal age ranged from 21–39 years.Three patients had preserved left ventricular function while one had moderately decreased function.Gestational age at presentation ranged from 6–15 weeks.There were three successful pregnancies(mean gestational age=37 weeks,range 35–39 weeks)with one patient accounting for two unsuccessful pregnancies.All infants were delivered via Cesarean section.One infant required a NICU stay,but all other infants delivered were healthy.Conclusion:Patients with Shone complex can have successful pregnancies although complications can occur for both the mother and the baby.Comprehensive prenatal care,coordinated and consistent management during pregnancy,and tertiary care support can promote positive maternal and fetal outcomes.
