Innovations 2022 in pediatric cardiology

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

Summary :

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.

Key Words

Coarctation of the aorta, prenatal diagnosis, fetal screening, postural tachycardia syndrome, autonomic dysfunction, vaccine-induced, pulmonary hypertension, congenital heart disease, pulmonary arterial dilating drugs