Научная статья на тему 'Possible non-spending diagnosis of a rare form of congenital heart disease - of total anomalous pulmonary venous drainage'

Possible non-spending diagnosis of a rare form of congenital heart disease - of total anomalous pulmonary venous drainage Текст научной статьи по специальности «Клиническая медицина»

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Ключевые слова
TADPV / congenital heart disease / X-ray / ECG and echocardiography / ТАДЛВ / ВПС / рентгенографєѐ / ЭКГ / ЭхоКГ.

Аннотация научной статьи по клинической медицине, автор научной работы — E.N. Shorina, G. Uksukbaeva, N. Orumbaev, Z. Nemetova

Total anormal drainage of pulmonary veins (TADPV) is insufficiently known and rarely occurring congenital heart defect, combining with other heart defect of the heart.The object is to diagnose TADPV in condition of policlinic level of studies. The children were examined by raentgenography, electrocardiogram which together with clinical manifestations allowed to diagnose this defect and to determine its type. All these investigations were perfomed in polyclinic conditions.

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ТАДЛВ МАЛОИЗУЧЕННЫЙ И РЕДКО ВСТРЕЧАЮЩИЙСЯ ВПС, СОЧЕТАЮЩИЙСЯ С ДРУГИМИ ПОРОКАМИ СЕРДЦА

дєагностєка ТАДЛВ в условєѐх полєклєнєческого уровнѐ єсследованєѕ. Детѐм проводєлє єсследованєѐ R-графєє органов грудноѕ клеткє, ЭхоКГ,ЭКГ, которые в совокупностє с клєнєческємє проѐвленєѐмє поѓволєлє выѐвєть этот порок є определєть его тєп. А этє обследованєѐ выполнєть в условєѐх полєклєнєкє.

Текст научной работы на тему «Possible non-spending diagnosis of a rare form of congenital heart disease - of total anomalous pulmonary venous drainage»

Вестник КазНМУ, №2(2)- 2014

I. KARIBAYEVA, S. AMIREEV, A. NAZHMEDENOVA, A. KUATBAYEVA

INCIDENCE OF PNEUMOCOCCAL PNEUMONIA IN CHILDREN OF EARLY AGE

Resume: Pneumococcal infection in children is manifested in the form of acute otitis media to clinical pneumonia and invasive pneumococcal disease. Immunization today is a successful control facility of pneumococcal infection. The share of the incidence of pneumonia of children below 2 years is 70.5% (Mangistau Region). Infants who are 2 years old or younger are at risk for pneumonia. Keywords: the incidence, pneumonia, etiology

И.К. КАРИБАЕВА, С.А. АМИРЕЕВ., А.Г. НАЖМЕДЕНОВА, А.М. КУАТБАЕВА

ЕРТЕ ЖАСТАГЫ БАЛАЛАРДЫЦ ПНЕВМОКОККТЫ ПНЕВМОНИЯМЕН СЫРКДТТАНУШЫЛЫГЫ

Туйш: Пневмококкты инфекция жедел орта отитген клиникалы^ пневмонияга дешн жэне инвазивт пневмококкты инфекцияга дешнп кeрiнiстерiмен ай^ындалатын кYPделi инфекция болып табылады. БYгiнгi тацда вакцинация пневмококкты инфекцияны бас^арудагы бiрден бiр эдк болып келедi. 2 жас^а дешнп балалардыц пневмониямен сыр^аттанушылыыныц Yлес салмагы 70,5% ^урады (Мацгыстау облысы). Ем жас^а дейiнгi балалар пневмония бойынша 1^аут-1^атер тобын прайды. ТYйiндi свздер: сыр^аттанушылы^, пневмония, этиология

UDK - 616.12 - 007.2 - 053.1 - 07 : 616,141 - 089,4.

E.N. SHORINA, G. UKSUKBAEVA, N. ORUMBAEV, Z. NEMETOVA

Department of internship and residency in pediatrics № 2

POSSIBLE NON-SPENDING DIAGNOSIS OF A RARE FORM OF CONGENITAL HEART DISEASE - OF TOTAL ANOMALOUS

PULMONARY VENOUS DRAINAGE

Total anormal drainage of pulmonary veins (TADPV) is insufficiently known and rarely occurring congenital heart defect, combining with other heart defect of the heart.The object is to diagnose TADPV in condition of policlinic level of studies. The children were examined by raentgenography, electrocardiogram which together with clinical manifestations allowed to diagnose this defect and to determine its type. All these investigations were perfomed in polyclinic conditions.

Keywords: TADPV, congenital heart disease, X-ray, ECG and echocardiography.

TAPVD - one of the rare defects at 0.5 - 4% of all CHD in combination with other heart defects. Until our years it is poorly understood. Diagnosis blemish is very difficult for a cardiologist clinic. CDH was created by J.B. Wenslow and J.Y. Wilson in 1739. Darling classification distinguishes 4 types of vice, depending on the level of the confluence of the pulmonary veins into the systemic circulation. IBOvercarcbl - pulmonary veins empty into a common header into the superior vena cava, left unmarked in the azygos vein. IBCardia- pulmonary veins empty into the right atrium or into the coronary sinus.

mUndercardial- pulmonary veins empty into the portal vein or inferior vena Vienna.

mMixed Various combinations of these types. Purpose of the work was the optimization of the diagnosis of total anomalous drainage under outpatient - polyclinic level research. Present their observations.

Patient N. 3 months admitted to the intensive care unit of Almaty General Hospital with complaints of cough, anxiety, poor weight gain.

Of history - by 4 months pregnant mother had SARS and worked in a foundry.

Patient's condition was very serious due to cardiovascular disease. RR - 68 per minute, Ps - 162. Limp slowly sucks. 3950 body weight, height - 55 cm. Of peripheral edema net. Tsianoz visible mucous and skin. In the lung against the hard breathing in the lower listened wet finely wheezing. Rhythmic heart sounds, the deaf, the second tone of the pulmonary artery strengthened.

Auscultated systolic murmur, with its epicenter along the left sternal border, which takes place on the cardiac region. Mild stomach, liver 3,5-3,5-3,0, supple texture.

ECG - sinus rhythm, and tachycardia. pulse 169, EAH deviation to the right of right heart.

X-ray - an increase of the right heart, the signs of pulmonary hypertension.

Echocardiography - pattern typical for TAPVD, ventricular septal defect, atrial septal defect.

After these consultations, the child was sent for surgery to Astana. Patient K. 2 months, was admitted to the emergency department with complaints of shortness of breath, anxiety. One week before admission, she was treated in one State Children's Hospital of Almatys diagnosed pneumonia, was discharged without improvement.

Patient's condition was very serious due to cardiovascular disease and respiratory failure. Ps 196, RR - 84. No peripheral edema. Cyanosis of the skin. Very restless, does not suck, shortness of breath with auxiliary muscles. In the lungs very hard breathing. Border of the relative cardiac dullness extended across, dull tones, 2 tone of the pulmonary artery is split, systolic murmur, with its epicenter - along the left sternal border, held for the cardiac region. Deep palpation of the abdomen is available, the liver 2,0-2,52,5.

ECG - sinus rhythm and tachycardia 196, EAH deviation to the right, signs of right ventricular hypertrophy. X-ray - ADPV, ventricular septal defect, hypertension. Echocardiography - ADPV, ventricular septal defect. 3 hours after admission with an increase in cardiac and respiratory failure, the child was transferred to the artificial lung vantilyatsiyu. With symptoms of terminal heart and respiratory failure death occurred.

Pathological-anatomical diagnosis ADPV - all the veins empty into the right atrium.

Вестник КазНМУ, №2(2)- 2014

Thus, in both cases, children prior to entering our clinic were diagnosed colds.

Data Clinic: shortness of breath, tachycardia, expanding the

boundaries of the heart, right ventricular overload, data

intsrumentalnogo survey, echocardiography, ECG, R-graphy - are not expensive and can be performed at outpatient examinations of children.

REFERENCES

1 Н.А. Белоконь, М.Б. Кубергер. Болезни сердца и сосудов у детей, руководство для врачей М.: Медицина, 1987 г. - 280 с.

2 А.С. Шарыпин, Врожденные пороки сердца. Руководство для педиатров, кардиологов, неонатологов. - М.: 2005 г. - С. 182-183.

3 А.В. Иваницкий, Ж.К. Халубаев, Б.И. Подашев. Аномальный дренаж легочных и системных вен. - Алматы: 1991 г. - С. 14-15.

4 Эхокардиографическая диагностика аномального дренажа легочных вен А.А. Бокерия, А.В. Иваницкий и др. издательство НЦССх им. Н.А. Бакулева, РАМН 2004 г. - С.17-18.

АЗ ЗЕРТТЕЛГЕН ЖЭНЕ СИРЕК КЕЗДЕСЕТ1Н ТПЖА-вЗГЕ ЖУРЕК АКАУЛАРЫМЕН Б1РГЕ ЖУРЕТ1Н вКПЕ КвКТАМЫРЛАРЫН ЖАППАЙ АНОМАЛЬДЫ ДРЕНАЖЫ

ТYйiн: 9КЖАД-Ц емханалы^ децгейдеп диагносгикальщ - зерттеу шарттары. Балаларта мынадай зерттеулер жYргiзiлдi: кеуде^уысы агзаларыныц R-графиясы, ЭхоКГ? Экг? Аталган зерттеулер жэне клиникалы^ кeрiнiстерi ар^ылы аталган а^ауды жэне оныц тYрiн аны^тауга кемектесп. Ал бул зерттеулердi емхана жагдайында жYргiзуге мYмкiндiк бар. ТYйiндi свздер: ТАДЛВ, жYректiц тумыстан а^ауы, рентгенография, экг, эхокардиография.

ТАДЛВ МАЛОИЗУЧЕННЫЙ И РЕДКО ВСТРЕЧАЮЩИЙСЯ ВПС, СОЧЕТАЮЩИЙСЯ С ДРУГИМИ ПОРОКАМИ СЕРДЦА

Резюме: диагностика ТАДЛВ в условиях поликлинического уровня исследований. Детям проводили исследования R-графии органов грудной клетки, ЭхоКГ,ЭКГ, которые в совокупности с клиническими проявлениями позволили выявить этот порок и определить его тип. А эти обследования выполнить в условиях поликлиники. Ключевые слова: ТАДЛВ, ВПС, рентгенография, ЭКГ, ЭхоКГ.

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