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Medium vessel vasculitis
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Cardiovascular manifestations during the acute/subacute phase or after convalescence are the main contributors to morbidity and mortality and make prompt diagnosis and treatment essential. During the acute episode, all three layers of the heart, i.e., the pericardium, myocardium, and endocardium, may be inflamed. A hyperdynamic precordium with tachycardia, systolic flow murmurs, and a gallop rhythm due to decreased ventricular compliance as a result of myocardial inflammation may be present in the acute phase. Myocarditis has been demonstrated in 50%–70% of KD patients [62].
The Child With Suspected Congenital Heart Disease
Published in Michael B O’Neill, Michelle Mary Mcevoy, Alf J Nicholson, Terence Stephenson, Stephanie Ryan, Diagnosing and Treating Common Problems in Paediatrics, 2017
Michael B O’Neill, Michelle Mary Mcevoy, Alf J Nicholson, Terence Stephenson, Stephanie Ryan
The ductus arteriosis connects the descending aorta (distal to the origin of the left subclavian artery) to the left pulmonary artery. In the foetus, the duct allows blood to flow from the pulmonary artery into the aorta, thereby bypassing the lungs and allowing oxygenation in the placenta. A PDA is defined as persistence of the ductus arteriosus beyond 1 month of age. The ductus arteriosus normally closes in the first 72 hours after birth. Failure of the duct to close is common in premature infants with up to 50% of preterm infants under 1500 g having a PDA. Small PDAs are usually asymptomatic, whereas a large PDA causes recurrent lower respiratory infections, failure to thrive and heart failure. Examination reveals a continuous machinery murmur below the left clavicle, a hyperdynamic precordium and bounding peripheral pulses.
Utility of the Platelet-to-Lymphocyte Ratio in Diagnosing and Predicting Treatment Success in Preterm Neonates with Patent Ductus Arteriosus
Published in Fetal and Pediatric Pathology, 2021
Birol Karabulut, Baran Cengiz Arcagök
Our hospital follows the policy of performing routine echocardiography at 24–72 hours of birth or at the onset of clinical signs (whichever happens first) in all neonates of gestational age <34 weeks [13]. The neonates were divided into two groups. Group 1: Preterm infants with hsPDAs Group 2: Preterm infants with non-hsPDA. Preterm infants with at least 1 of the following clinical signs of PDA (hyperdynamic precordium, continuous murmur, tachycardia, hypotension, oliguria, increase in pulse pressure, increase in tension and/or oxygen need) and at least 1 of the following echocardiography findings (ductal diameter ≥1.5 mm, left atrium/aorta root ratio ≥1.5, and insufficient diastolic flow or reverse flow in the abdominal aorta) were categorized as infants with hsPDA and were treated for DA closure. Surveillance echocardiography was performed in all infants after medical treatment to confirm persistent vs. closed DA, and PDA closure was defined as the absence of ductal flow and called success of treatment. Echocardiography was performed by a neonatologist using the Vivid S6 Echocardiography System fitted with a 10S Transducer (General Electric Healthcare, Milwaukee, WI).
A rare giant placental chorioangioma with favourable outcome: a case report
Published in Journal of Obstetrics and Gynaecology, 2022
Ling Hong, Lingling Hua, Peijun Yao, Li Zhang
At birth, the baby girl had pallor, petechiae, hepatosplenomegaly, hyperdynamic precordium and tachypnea. She required oxygen through a nasal catheter at birth. A laboratory examination revealed a RBC count of 2.42 × 10∧12/L, hemoglobin of 8.8 g/dl, hematocrit of 28.7%, and a platelet count of 29 × 10∧9/L. Echocardiography indicated patent foramen ovale, patent ductus arteriosus, and a severe pulmonary hypertension, PG108mmHg, left ventricular ejection fraction was 61%. The neonate was intubated and admitted to the neonatal unit to receive a blood transfusion and was sent home 12 days later. The baby was followed up for 10 months and showed good growth and development.
The Association between Hemodynamically Significant Patent Ductus Arteriosus and 25-Hydroxyvitamin D Levels in Preterm Infants ≤32 Weeks Gestational Age
Published in Fetal and Pediatric Pathology, 2023
The presence of clinical findings such as murmur, hyperdynamic precordium, bounding pulses, worsening respiratory status, wide pulse pressure, hypotension and metabolic acidosos followed by confirmatory Doppler echocardiographic (ECHO) findings such as ductus with an internal diameter of ≥1.5 mm, left atrium/aortic root ratio of ≥1.5, left to right shunting, cardiomegaly and reversal of flow in postductal major arteries which was performed at 48 to 72 hours of life accepted as hsPDA [8].