new echocardiography method to assess the progress of the left ventricular outflow tract obstruction in children

Discrete subaortic stenosis is considered an acquired cardiac defect of postnatal development; usually appear after the first year of life and causes LVOT of rapid hemodynamic progression. The relationship between ridgeseptal angle and progress of LVOTO has not been evaluated yet. Our objective was to evaluate the ridgeseptal angle as an important risk factor for progress of LVOT obstruction. 19 patients enrolled in this study, 12 in group one [RSA was right angle], 5 patients with acute angle in group two and 2 patients were in group three [oubtuse angle], follow-up echocardiography study every 6 months for 2 years to evaluate the progression of LVOT obstruction for each group. A total of 19 patients enrolled in this study [mean ages 5.5 +/- 1.7 mmHg] were diagnosed as isolated DSS, group [1] with right angle [RSA] showed that gradient increased 4 +/- 2.2 mmHg after 2 years, 2 +/- 2 mmHg, 2 +/- 1.2 mmHg in the other two groups [2and3] respectively. The results demonstrated that the maximum progressions in LVOTO were found in right angle group 4mmHg after two years with no statistical significance. Our results demonstrated that the maximum increase in LVOTO were found in the right angel [RSA] patients group where the hydraulic dynamic force was a maximum value. We recommended to measure the RSA echocardiography in every patient with DSS to assess how fast the progress of LVOTO

Closure of ventricular septal defect: a predictive pattern

This is a follow-up study from 1995 to 1999. A large number of small VSDs close spontaneously, this number approaches 75% to 80%. Our objectives were to predict the incidence of small and moderate size VSD and also the pattern of closure of VSD. 79 patients enrolled in this study, 36 in group one [3 mm VSD], 21 in group two [4 mm VSD in diameter], both groups one and two were subdivided into perimembranous and muscular defects. Group three included 11 patients with moderate size VSD [5 mm in diameter]. 7 patients Were in group four with moderate size VSD [ranged between 6 mm to 9 mm]. Group five included 4 patients with Swiss-cheese type VSD. 76% of small perimembranous VSD of 3 mm in diameter, 57% of 3 mm muscular VSD closed spontaneously. Patients in group two, 65% of 4 mm perimembranous VSD and 25% of 4 mm muscular type closed spontaneously. Regarding to 5 mm moderate size VSD, 36% had a chance to close spontaneously. Our results demonstrated that the time of closure of perimembranous 3 mm at 26 +/- 6 months, muscular 3 mm at 36 +/- 5, 4 mm perimembranous and muscular at 38 +/- 8, 39 months respectively and 5 mm perimembranous at the mean age of 47 +/- 5 months. Spontaneous closure of small VSD occured in 38 out of 57 patients with an incidence of [64.5%], of these 46 had perimembranous defects and muscular defects were in 11 patients. The incidence of moderate size VSD 5 mm was 57% [3 out of II patients]

Profile of heart diseases in children

Heart diseases in children are considered one of the most important health problems in out country, our objective is to know the profile of heart disease in children. Data have been collected from January 1995 to December 1998. Data were collected from all new patients attending our clinic, new patients have been classified into six different categories [CHD, RHD, MVP, arrhythmia, normal and miscellaneous], recurrence risks of CHD among relatives and also delay in diagnosing CHD have been evatuated. 1636 patients enrolled in this study, of these 800 CHD. 177 RHD, 197 MVP, 346 normal, 27 arrhythmic and 89 miscellaneous patients, recurrence risks occurred in 12 out of 800 families with CUD. There was a statistically significant delay in diagnosing CUD in both South and North Sinai. CHD costituted the highest number of patients attending our outpatient clinic. A solitary VSD is the commonest morphologic congenital malformation accounting for about 36% of lesions. Innocent murmur was present in 26%. Delays in CUD diagnosis was due to both patient and doctor. There are different aspects of heart disease problem in our area [diagnosis, management, surgical repair and social part]. Collaboration between different Pediatric Cardiology Units to get an accurate incidence of CUD in our country