Jain Sunil
Department of Paediatrics, Military Hospital Secunderabad, Telangana, India.
J Family Med Prim Care. 2021 Sep;10(9):3178-3184. doi: 10.4103/jfmpc.jfmpc_59_21. Epub 2021 Sep 30.
Pertinent perspectives for practical applications is advantageous professionalism. Congenital heart diseases (CHDs) are of varied types, severity, and complexity. Simple scientific approach along with sophistication is required for successful management at all levels. We gleaned important information from published evidence and authoritative resources and have put things in practical perspective. These include current prevention, care, correction, cure, and rehabilitation strategies for robust practices. Prospective prevention is with preconception counseling and addressing environmental factors. Fetal echocardiography and nondirective genetic counseling are important. Early detection and expert diligence is desirable. The suspicion is clinical. A number of clinical and investigative diagnostic modalities are available and should be utilized as guided by the clinical cues. Medical management includes general health maintenance, immunizations, monitoring, and complications treatment. Pediatric interventional cardiology is making rapid strides and treating many types of lesions. Understanding of procedure done is a prerequisite of follow-up care. Surgery is of curative, reparative, or palliative types. After surgical correction in early childhood long-term sequelae are rare. After reparative surgery some have life-long sequelae and some have significant late impairment. The number of postintervention/surgery survivors into adulthood is increasing. Microsurgical techniques are leading the way for precision and fewer complications. Follow-up care with "Ten Points Information and Action Plan (TP-IAP)" is suggested. The Armed Forces scenario involves frequent movements to difficult and harsh conditions. Special precautions for affected children needed. Cardiovascular health is enhanced by avoiding a sedentary lifestyle and obesity. Various intrinsic and extrinsic factors limiting functioning need to be suitably addressed.
对实际应用而言,相关观点有助于展现专业素养。先天性心脏病(CHD)具有多种类型、严重程度和复杂性。在各个层面成功管理此类疾病需要采用简单科学的方法并具备精湛的技术。我们从已发表的证据和权威资源中收集了重要信息,并从实际角度进行了梳理。这些内容包括当前用于稳健实践的预防、护理、矫正、治愈和康复策略。前瞻性预防包括孕前咨询和应对环境因素。胎儿超声心动图和非指导性遗传咨询很重要。早期检测和专家的悉心照料是可取的。诊断主要依靠临床判断。有多种临床和检查诊断方法可供使用,应根据临床线索加以运用。药物治疗包括一般健康维护、免疫接种、监测和并发症治疗。小儿介入心脏病学正在迅速发展,可治疗多种类型的病变。了解所施行的手术是后续护理的前提。手术有根治性、修复性或姑息性之分。幼儿期进行手术矫正后,长期后遗症很少见。修复性手术后,有些人有终身后遗症,有些人有严重的后期损害。干预/手术后存活至成年的人数正在增加。显微外科技术正引领着提高精准度和减少并发症的方向。建议采用“十点信息与行动计划(TP - IAP)”进行后续护理。军队环境中,人员经常要前往困难和恶劣的地区。需要对患病儿童采取特殊预防措施。避免久坐不动的生活方式和肥胖有助于增强心血管健康。需要适当应对限制功能的各种内在和外在因素。