Inpatients with congenital heart disease complicated with pulmonary arterial hypertension: An analysis of patient composition and clinical features
10.3724/SP.J.1008.2008.00306
- Author:
Yan GUO
1
Author Information
1. Department of Cardiology
- Publication Type:Journal Article
- Keywords:
Congenital heart defects;
Diagnosis;
Epidemiology;
Hospitalization;
Pulmonary hypertension
- From:
Academic Journal of Second Military Medical University
2010;29(3):306-310
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the composition and clinical features of inpatients with congenital heart disease (CHD) complicated with pulmonary arterial hypertension (PAH) from a cardiovascular department. Methods: We retrospectively analyzed the clinical data of 238 PAH patients who were identified from 3 674 CHD inpatients in Changhai Hospital during Jan, 2001 to Jul, 2007. Results: Among the 3 674 CHD inpatients who were treated in our hospital in recent 6 years, 238 (6.48%) had PAH. PAH was found in 10.8% of patients with atrial septal defect (ASD), 2.81% of patients with ventricular septal defects (VSD), 5.57% of patients with patent ductus arteriosus (PDA), and 19.6% of patients with complex types. The mean age of patients was (45.6 ± 17.7) years, with 49.6% of them being 40-60 years. Female patients accounted for 69.3% of the total. The composition of PAH patients was: ASD (62.6%), VSD(19.7%), and PDA(13.4%). The patients with VSD, PDA or other complex types were younger than those with ASD(P<0.01). More female PAH patients had ASD than VSD (76.5% vs 44.7%,P<0.01). Most patients had chest distress and dyspnea on exertion as initial symptoms and accentuated pulmonary component of the second heart sound as physical sign; they also had increased cardiothoracic ratio, prominent, dilated central pulmonary arteries on chest radiography, right ventricle enlargement, and incomplete right bundle branch block on ECG. The pulmonary artery systolic pressure(sPAP), as estimated by echocardiography, had a significant correlation with catheterization measurements(r=0.734,P<0.01). Conclusion: PAH is common in patients with CHD, especially in females, those with ASD, and those of 40-60 years old. The clinical presentation, chest radiography and ECG are normal. Echocardiography has important diagnosis value. There is a correlation between echocardiography and catheterization measurements of sPAP.
