Anomalous left coronary artery from the pulmonary artery(ALCAPA) is most commonly diagnosed within the first year of life with congestive heart failure symptomatology reflecting left ventricle(LV) dysfunction. The lat...Anomalous left coronary artery from the pulmonary artery(ALCAPA) is most commonly diagnosed within the first year of life with congestive heart failure symptomatology reflecting left ventricle(LV) dysfunction. The late diagnosis of ALCAPA is presented in a 5-yearold without significant LV dysfunction, mild LV dilatation and only mild mitral regurgitation that did not change significantly after surgery. The timing of surgical intervention in the late diagnosis of ALCAPA remains unclear despite risks of significant ongoing myocardial injury secondary to coronary artery hypoperfusion and progressive mitral valve dysfunction. Intervention in this case allows for revascularization which may reverse ventricular and valvular dysfunction.展开更多
AIM:To evaluate the prevalence of hypertension and/or left ventricular hypertrophy(LVH) in children with a diagnosis of obstructive sleep apnea(OSA).METHODS:A cross-sectional case series of consecutive,otherwise healt...AIM:To evaluate the prevalence of hypertension and/or left ventricular hypertrophy(LVH) in children with a diagnosis of obstructive sleep apnea(OSA).METHODS:A cross-sectional case series of consecutive,otherwise healthy children aged > 4 years,with polysomnography-proven OSA [apnea hypopnea index(AHI) > 1.5/h] is described.Echocardiography was performed on all subjects and left ventricular mass was calculated.Study subjects underwent additional investigation with 24-h ambulatory blood pressure(BP) monitoring.RESULTS:Thirty children(21 males) were studied.Mean age was 8.9 years.Mean body mass index was 19.87 kg/cm2.Mean AHI was 14.3/h.10/30(33%) of the study population met criteria for pre-hypertension(n = 3) or masked hypertension(n = 7) based on standard ambulatory monitoring criteria.All 10 children had systolic hypertension throughout the night with 5 of these also having elevated daytime systolic readings.There was a relationship between AHI and BP showing an increase of 1.162 percentile units in mean diastolic night BP(age,gender and height specific) per unit increase in AHI(P = 0.018).There were no subjects with LVH and/or right ventricular hypertrophy.CONCLUSION:In our population of otherwise healthy Caucasian children,there was a high prevalence of hypertension that would not have been identified using standard office/clinic protocols.展开更多
文摘Anomalous left coronary artery from the pulmonary artery(ALCAPA) is most commonly diagnosed within the first year of life with congestive heart failure symptomatology reflecting left ventricle(LV) dysfunction. The late diagnosis of ALCAPA is presented in a 5-yearold without significant LV dysfunction, mild LV dilatation and only mild mitral regurgitation that did not change significantly after surgery. The timing of surgical intervention in the late diagnosis of ALCAPA remains unclear despite risks of significant ongoing myocardial injury secondary to coronary artery hypoperfusion and progressive mitral valve dysfunction. Intervention in this case allows for revascularization which may reverse ventricular and valvular dysfunction.
基金Supported by Partially funded by the Alberta Children's Hospital Foundation
文摘AIM:To evaluate the prevalence of hypertension and/or left ventricular hypertrophy(LVH) in children with a diagnosis of obstructive sleep apnea(OSA).METHODS:A cross-sectional case series of consecutive,otherwise healthy children aged > 4 years,with polysomnography-proven OSA [apnea hypopnea index(AHI) > 1.5/h] is described.Echocardiography was performed on all subjects and left ventricular mass was calculated.Study subjects underwent additional investigation with 24-h ambulatory blood pressure(BP) monitoring.RESULTS:Thirty children(21 males) were studied.Mean age was 8.9 years.Mean body mass index was 19.87 kg/cm2.Mean AHI was 14.3/h.10/30(33%) of the study population met criteria for pre-hypertension(n = 3) or masked hypertension(n = 7) based on standard ambulatory monitoring criteria.All 10 children had systolic hypertension throughout the night with 5 of these also having elevated daytime systolic readings.There was a relationship between AHI and BP showing an increase of 1.162 percentile units in mean diastolic night BP(age,gender and height specific) per unit increase in AHI(P = 0.018).There were no subjects with LVH and/or right ventricular hypertrophy.CONCLUSION:In our population of otherwise healthy Caucasian children,there was a high prevalence of hypertension that would not have been identified using standard office/clinic protocols.
