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Rubella syndrome. Cardiovascular manifestation and surgical therapy in infants
Insights
Congenital rubella syndrome can cause serious heart defects like patent ductus arteriosus and pulmonary artery stenosis in infants. Early diagnosis and treatment, including surgery, improve outcomes for affected children.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Rubella Syndrome
Background:
- Congenital rubella syndrome (CRS) is associated with significant cardiovascular manifestations.
- Cardiac defects are a major cause of morbidity and mortality in infants with CRS.
Purpose of the Study:
- To describe the spectrum of cardiovascular anomalies in infants with CRS.
- To evaluate the diagnostic methods and therapeutic outcomes for cardiac complications of CRS.
Main Methods:
- Retrospective review of nine infants under five months of age with cardiovascular manifestations of CRS.
- Clinical examination, echocardiography, cardiac catheterization, and cineangiography were utilized for diagnosis.
- Surgical intervention (patent ductus arteriosus ligation) was performed in selected cases.
Main Results:
- Six out of nine infants had patent ductus arteriosus (PDA); three of these also had pulmonary artery stenosis (PAS).
- One infant presented with isolated bilateral PAS. Axillary murmurs and right ventricular hypertrophy were key clinical findings for PAS diagnosis.
- Two infants had ventricular septal defects (VSD) as their sole cardiac anomaly.
- Six infants underwent PDA interruption due to severe congestive heart failure or failure to thrive, with satisfactory post-operative development.
Conclusions:
- Cardiovascular complications of CRS, including PDA and PAS, can be diagnosed and managed in early infancy.
- Early recognition and intervention, including surgical repair, are crucial for improving outcomes in infants with CRS-related heart defects.
Abstract:
Of nine patients under five months of age with cardiovascular manifestations of the rubella syndrome, six had patent ductus arteriosus. Three of these six also had pulmonary artery stenosis. One infant had bilateral isolated pulmonary artery stenosis. The significant clinical findings leading to the diagnosis of pulmonary artery stenosis were axillary murmurs in the presence of right ventricular hypertrophy. Demonstration of a gradient across the stenosis at the time of catheterization, together with cineangiography, established the diagnosis. In two cases ventricular septal defect was the only cardiac anomaly.Six babies under five months of age had interruption of a patent ductus arteriosus because of uncontrollable congestive heart failure or failure to thrive. Although growth failure was not necessarily due to heart disease, all were developing satisfactorily following operation.Diagnosis and therapy of the cardiac complications of the rubella syndrome is possible in the first few months of life. Early recognition of cardiac defects in the young infant with the rubella syndrome permits aggressive medical management and in selected instances surgical therapy.