ABSTRACT
This was a cross-sectional survey in which 80 children with malignancies were studied at the Kenyatta National Hospital to determine cardiac status before and during cancer therapy. An equal number of age and sex matched subjects admitted to the surgical wards for minor procedures was recruited as a comparison group. All the subjects underwent clinical cardiac assessment. Chest radiographs, electrocardiograms (ECG), echocardiograms, haemograms and renal function tests were also performed. Overall, 13 cases (16.3%) had abnormal cardiac findings compared to 7 (8%) in the comparison group (p = 0.429). Sixteen, two and five subjects had abnormal velocity of circumferential fibre shortening, ejection fraction and pericardial effusion respectively. Three out of the five subjects with pericardial effusion were cancer patients who had not undergone treatment. Mitral valve prolapse with regurgitation was diagnosed in one cancer patient. Though not statistically significant, children with malignancies appear to have a higher frequency of acquired cardiac abnormalities than those without cancers. Since a larger proportion of the abnormalities occurred in cancer children before commencement of treatment, the pathology is more likely to have resulted from the malignancies than therapy. There was no evidence to suggest that cancer treatment contributed to cardiac morbidity. We recommend that all oncology patients undergo cardiac evaluation on admission.
Subject(s)
Heart Diseases/etiology , Neoplasms/complications , Case-Control Studies , Child , Cross-Sectional Studies , Female , Heart Diseases/diagnosis , Hospitals, Urban , Humans , Kenya , Male , Morbidity , Neoplasms/therapy , PrevalenceABSTRACT
Percutaneous transluminal baloon valvuloplasty is currently the treatment of choice for most cases of pulmonary valve stenosis. In the first series of cases performed at Kenyatta National Hospital, six patients aged 4 to 24 years with severe pulmonary valve stenosis and no other associated cardiac lesions were selected for the procedure. Immediately following baloon valvuloplasty, the pressure gradients across pulmonary valve measured by both echo-Doppler technique and cardiac catheterisation dropped very significantly (P < 0.001). Catheterisation peak systolic gradients (psg) dropped from 162.5 +/- 23.7 to 56.5 +/- 19.0 while echo-Doppler pressure gradients dropped from 112.0 +/- 11.9 to 42.8 +/- 16.0. No complications occurred during or after the procedure. This initial short-term experience in our set-up confirms the safety and effectiveness of this procedure. Furthermore, this procedure is much cheaper and technically easier to perform than cardiac surgery.
Subject(s)
Catheterization/methods , Hemodynamics , Pulmonary Valve Stenosis/therapy , Adolescent , Adult , Cardiac Catheterization , Child , Echocardiography , Follow-Up Studies , Humans , Pulmonary Valve Stenosis/diagnostic imaging , Pulmonary Valve Stenosis/physiopathology , Treatment OutcomeABSTRACT
Analysis of data concerning 24 patients with mitral stenosis treated surgically is presented. Twenty patients had closed valvotomy with good results in 19 of them. One patient died post operatively from cerebral embolism. Closed mitral valvotomy is recommended in selected cases.
