RESUMO
OBJECTIVE: The main objective of this study was to ascertain if a structured intervention programme can improve the biophysical health of young children with congenital heart disease (CHD). The primary end point was an increase in measureable physical activity levels following the intervention. METHODS: Patients aged 5-10 years with CHD were identified and invited to participate. Participants completed a baseline biophysical assessment, including a formal exercise stress test and daily activity monitoring using an accelerometer. Following randomisation, the intervention group attended a 1 day education session and received an individual written exercise plan to be continued over the 4-month intervention period. The control group continued with their usual level of care. After 4 months, all participants were reassessed in the same manner as at baseline. RESULTS: One hundred and sixty-three participants (mean age 8.4 years) were recruited, 100 of whom were male (61.3%). At baseline, the majority of the children were active with good exercise tolerance. The cyanotic palliated subgroup participants, however, were found to have lower levels of daily activity and significantly limited peak exercise performance compared with the other subgroups. One hundred and fifty-two participants (93.2%) attended for reassessment. Following the intervention, there was a significant improvement in peak exercise capacity in the intervention group. There was also a trend towards increased daily activity levels. CONCLUSION: Overall physical activity levels are well preserved in the majority of young children with CHD. A structured intervention programme significantly increased peak exercise capacity and improved attitudes towards positive lifestyle changes.
Assuntos
Tolerância ao Exercício/fisiologia , Cardiopatias Congênitas/reabilitação , Prescrições , Qualidade de Vida , Criança , Pré-Escolar , Análise Custo-Benefício , Terapia por Exercício , Feminino , Seguimentos , Cardiopatias Congênitas/fisiopatologia , Humanos , Estilo de Vida , Masculino , Estudos ProspectivosRESUMO
CLINICAL INTRODUCTION: A young man attended the adult congenital heart disease clinic for routine follow-up. He had a diagnosis of transposition of the great arteries (TGA) and underwent a Senning procedure at 10â months of age. He had remained well over the intervening years, was fully saturated, with a normal exercise tolerance, no cardiovascular symptoms and no history of arrhythmia or symptoms suggesting thromboembolic events. Transthoracic echocardiogram is shown in figure 1A and cardiac MRI image in figure 1B. QUESTION: Which of the following is the most likely diagnosis? Intact atrial pathwaysSecundum atrial septal defectBaffle leakPrimum atrial septal defectBaffle obstruction.
Assuntos
Transposição das Grandes Artérias/efeitos adversos , Ecocardiografia Doppler em Cores , Imageamento por Ressonância Magnética , Complicações Pós-Operatórias/diagnóstico por imagem , Transposição dos Grandes Vasos/cirurgia , Adulto , Aspirina/uso terapêutico , Fibrinolíticos/uso terapêutico , Humanos , Lactente , Masculino , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/etiologia , Valor Preditivo dos Testes , Fatores de Tempo , Resultado do TratamentoAssuntos
Cardiologia/estatística & dados numéricos , Doenças Cardiovasculares/epidemiologia , Encaminhamento e Consulta/estatística & dados numéricos , Centros de Atenção Terciária/estatística & dados numéricos , Carga de Trabalho/estatística & dados numéricos , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Irlanda , Masculino , Pacientes Ambulatoriais/estatística & dados numéricos , Estudos RetrospectivosRESUMO
Pulmonary calcification is uncommon in children. It is rarely described following cardiac surgery. Here, the authors describe the case of an infant who developed extensive pulmonary calcification following the repair of truncus arteriosus.