Diagnostics and treatment of congenital heart diseases in newborns
- Authors: Mirolyubov LM1, Petrushenko DY.2, Kalinicheva JB2, Sabirova DR3
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Affiliations:
- Kazan State Medical University, Kazan, Russia
- Children’s Clinical Hospital of the Health Ministry of the Republic of Tatarstan, Kazan, Russia
- Kazan State Medical Academy, Kazan, Russia
- Issue: Vol 96, No 4 (2015)
- Pages: 628-632
- Section: Theoretical and clinical medicine
- URL: https://journals.rcsi.science/kazanmedj/article/view/2263
- DOI: https://doi.org/10.17750/KMJ2015-628
- ID: 2263
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Abstract
Aim. Early detection and timely appropriate surgical treatment of congenital heart disease in order to reduce infant mortality.
Methods. The algorithm was designed for the prediction of critical conditions in congenital heart disease in newborns. The algorithm is simple to use, because it does not set a pediatrician-neonatologist a difficult task for the accurate diagnosis of congenital heart disease, but leads physician from the syndromic diagnosis to a certain group of diseases and, therefore, appropriate strategy of patient treatment and management. The algorithm combines both syndromes and hemodynamic conditions causing them. The conditions are divided into fetal-dependent and fetal-independent, which determines the time of surgery. The questionnaire consisting of a series of questions with multiple choice answers helps the doctor to see into the symptoms and syndromes. The questions are made in a way to emphasize the certain signs, the details of medical history and disease progression to pediatricians. It is important to notice that 13 out of 20 questions are based on the medical history and clinical picture, 7 questions are based on the test results such as electrocardiography, radiography, and do not include echocardiography.
Results. Since 2000, the questionnaire was implemented in the Republic of Tatarstan as a recommended diagnostic algorithm for examining newborns with congenital heart disease. Since 2003, the questionnaire and algorithm for prediction of the critical conditions was introduced by the order №867 of the Ministry of Health of the Republic of Tatarstan «On measures to improve health care in congenital heart disease in children». Remote consultations with maternity hospitals are strictly based on them. They carry a certain training load, and when doctors pronounce aloud all the items of the test, the examination algorithm gradually becomes automatic.
Conclusion. During 13 years of using the proposed diagnostic algorithm for congenital heart disease with physiological rationale for palliative care and timely terms of surgery, the mortality rate from congenital heart disease in the Republic of Tatarstan has significantly dropped.
About the authors
L M Mirolyubov
Kazan State Medical University, Kazan, Russia
Author for correspondence.
Email: mirolubov@mail.ru
D Yu Petrushenko
Children’s Clinical Hospital of the Health Ministry of the Republic of Tatarstan, Kazan, Russia
Email: mirolubov@mail.ru
J B Kalinicheva
Children’s Clinical Hospital of the Health Ministry of the Republic of Tatarstan, Kazan, Russia
Email: mirolubov@mail.ru
D R Sabirova
Kazan State Medical Academy, Kazan, Russia
Email: mirolubov@mail.ru
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