Innovations 2022 in pediatric cardiology

Jelena Hubrechts, Catherine Barrea, Lien Meirlaen, Karlien Carbonez, Stéphane Moniotte Published in the journal : February 2023 Category : Cardiologie pédiatrique

In 2022, three major themes in pediatric cardiology have captured our attention. From fetal life to adolescence, these topics are very varied and thus illustrate the broad field of competence of our team of pediatric cardiologists.

First, despite coarctation of the aorta (CoAo) being one of the most common congenital heart diseases, its prenatal diagnosis remains challenging. Because of the subtlety of the ultrasound signs of CoAo during the morphological examination in the second trimester of pregnancy, screening is difficult. Yet, the prognosis of these patients depends on prompt management in the neonatal period. The development of fetal cardiac MRI and improved knowledge in cardio-genetics tend to improve fetal detection of CoAo.

Second, postural tachycardia syndrome (POTS) affects the quality of life of adolescent patients. Simple indicators such as heart rate and blood pressure during a head-up tilt test have a predictive value regarding treatment efficiency and prognosis in children with POTS. Recently, a new hypothesis has suggested vaccine-induced autoimmune POTS following mRNA COVID-19 vaccination.

Third, postoperative pulmonary hypertension (PH) after correction of congenital heart defects is a serious and potentially lethal complication. In recent years, PH-targeting drugs have been increasingly used in the postoperative setting. The scientific evidence of an improved outcome is discussed in the last part of this manuscript.

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What is the progress made in pediatric cardiology in 2020?

Jelena Hubrechts, Madeline Barbier, Coralie De Bruyne, Sylvie Lommaert, Mieke Roggen, Laetitia Vanhoutte, Christophe Vô, Stéphane Moniotte Published in the journal : February 2021 Category : Cardiologie pédiatrique

Despite the worldwide health crisis, different advances were made in pediatric cardiology in 2020. This paper discusses six different topics, the first being related to the ongoing pandemic and the last one being a review of the last two decades’ advances made in this field.

During the SARS-CoV-2 pandemic, an unexpected high number of children were admitted, presenting with Kawasaki disease and coronary dilatation. Moreover, in 2021, a new clinical entity arose, which is referred to as multisystem inflammatory syndrome, which was temporarily associated to COVID-19 (MIS-C).This new clinical condition shared similarities with atypical Kawasaki disease, even though the patients’ median age tended to be higher, while a significant left ventricular dysfunction was mostly the prominent cardiac feature at the time of diagnosis. Treatment guidelines of Kawasaki disease were reviewed in the light of this recent outbreak of patients presenting with MIS-C.

Other topics that have been addressed in this paper are the routine use of angiotensin-converting enzyme inhibitors (ACEI) in patients with single ventricle, as well as that of pulmonary artery banding in infants and children with end-stage dilated cardiomyopathy, in addition to cardiac resynchronization therapy. Lastly, the use of physical exercise in Fontan patients has been discussed before ending with an historical overview of the major advances made in congenital heart disease.

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Epidemiological particularities of Kawasaki disease in Luxembourg over the past decade: focus on infants under 12 months

Fanny Kubat, Armand Biver, Kerstin Wagner, Isabel De La Fuente Garcia Published in the journal : September 2017 Category : Cardiologie pédiatrique

Kawasaki disease is the leading cause of acquired heart disease in children. Its incidence is underestimated in infants aged less than 1 year. In this population, clinical manifestations are atypical. The diagnosis should therefore be suspected in infants with persistent fever, even if not all clinical signs are present, in order to avoid delaying the diagnosis and treatment and prevent harmful cardiovascular consequences. Echocardiography is a helpful diagnostic tool and should be performed promptly in case of Kawasaki disease suspicion.

Key Words

Kawasaki disease, incidence, infant, coronary arteries, intravenous immunoglobulin

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