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- The Mission Hospital,Immon Kalyan Sarani, Sector IIC, Bidhannagar, Durgapur, West Bengal 713212
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PEDIATRIC ECHOCARDIOGRAPHY:
- It is the gold standard to diagnose the heart defects in a child by trans-thoracic echocardiography.
- If the child is irritable oral sedatives like triclofos can be given, it is a relatively safe drug for performing pediatric echocardiography. Child may fall asleep for 2 hrs following the administration of the drug.
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CONTRAST ECHOCARDIOGRAPHY:
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It is an important tool to diagnose pulmonary A-V fistula or any case of unexplained cyanosis, an agitated saline is given via a peripheral canula by the assistant and the echocardiographer records the images.
TRANS-ESOPHAGEAL ECHOCARDIOGRAPHY(TEE):
- This is very much similar to an endoscopy test, it gives a better picture to diagnose heart defects like ASD, VSD and valvular lesions, especially in adults and adolescents. This test can be done like OPD procedures without sedation, however conscious sedation can be used in selected cases. Now-a-days 3D images can be obtained for better understanding of the anatomy.
- Pre-requisite: 6 hours fasting is mandatory prior to the test. COVID 19 RTPCR is also mandatory in many centers prior to the tests.
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Complication: though very rare in experienced hands, there are few incidences of Esophageal rupture.
FETAL ECHOCARDIOGRAPHY:
- It is basically an ultrasound test, which uses sound waves to produce images in the machine. This test is quite safe for the unborn baby (fetus), since no radiation is involved in this test. This test can be done anytime in the second trimester, but conventionally done between 20-24 weeks.
- INDICATION:
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If mother is taking any medications like anti-epleptic drugs, enalapril, warfarin, alcohol etc.
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If mother is having medical ailments like diabetes, hypothyroidism, Rubella, SLE, phenyl-ketonuria etc.
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If mother had undergone any surgery for CHD
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If there is any previous child birth with CHD
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Repeated fetal demise in mid-trimester/ bad obstetric history
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Abnormal anomaly scan
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IVF pregnancy
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SIGNIFICANCE OF FETAL ECHO:
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If any heart defect is detected then delivery should be done in a tertiary care hospital , where neonatal cardiac surgeries or interventions are done frequently
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Many of the heart defects can be fully corrected post natally, few cases are uncorrectable . those high risk pregnancies can be terminated after proper counselling
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Now a days fetal interventions are available for obstructive lesions like aotic and pulmonary stenosis.
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Fetal arrhythmias can be managed medically
ECG-PEDIATRIC & NEONATAL
- ECG of normal infants and children are quite different from adults
- This is an important tool to diagnose complete heart block, to differentiate between ventricular and supraventricular arrhythmias.
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Hypocalcemia prolongs QTc
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Hyperkalemia produces tall, peaked tented T waves
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J depression in II, III & aVF in young adults are physiological
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ECG can diagnose ventricular hypertrophies and pre-excitation syndromes.
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If you find any abnormality in your kid’s ECG, Please consult with Dr Nayak
24 HR HOLTER MONITORING
- A Holter monitor uses electrodes and a recording device to track the heart's rhythm for 24 to 72 hours.
- A health care provider can print an electrocardiogram strip using the data on the recording device to see the heart's rhythm during the period the monitor was worn
HEAD UP TILT TEST (HUTT)
- The head-up tilt test (HUTT) is an important tool to assess autonomic function and is used for differential diagnosis of transient loss of consciousness and orthostatic intolerance in adults and children.
- HUTT can be used to diagnose the hemodynamic type of orthostatic intolerance.
CHEST PAIN CLINIC
- Many children say their chest hurts at some point during their growth and development.
- Chest pain in children is rarely due to the heart.
- Still, you should feel free to ask Dr Nayak to figure out the reason for the pains.
VALVE CLINIC
- The clinics' core role is to follow patients with moderate or severe valve disease and refer for intervention at the correct time.
- To maintain the prosthetic valve patency proper medications and echocardiographic evaluation is done on a regular interval here at Durgapur.
GENETIC TESTING & COUNSELLING
- common genetic syndromes showing various types of congenital heart disease, including Down syndrome, Turner syndrome, 22q11 deletion syndrome(DiGeorge Syndrome), Williams syndrome, Noonan syndrome etc.
- Patients with genetic syndromes may be at an increased risk of death or major complications associated with surgery. Therefore, risk management based on an accurate genetic diagnosis is necessary in order to effectively plan the surgical and medical management and follow-up for these patients.
- In addition, multidisciplinary approaches and care for the combined extra-cardiac anomalies may help to reduce mortality and morbidity accompanied with congenital heart disease.
RISK FACTORS FOR CHD
- High Blood Pressure: Hypertension or high blood pressure can increase the risk of CHD. It causes damage to the inner walls of the arteries, which can lead to a buildup of plaque and reduce blood flow to the heart.
- High Cholesterol: High levels of LDL (bad) cholesterol in the blood can contribute to the formation of plaque in the arteries, increasing the risk of CHD.
- In addition, multidisciplinary approaches and care for the combined extra-cardiac anomalies may help to reduce mortality and morbidity accompanied with congenital heart disease.
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Smoking: Smoking damages the blood vessels, raises blood pressure, and increases the risk of blood clots, all of which can contribute to the development of CHD.
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Diabetes: People with diabetes are at an increased risk of developing CHD due to high blood sugar levels that can damage blood vessels.
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Family History: A family history of CHD can increase the likelihood of developing the condition.
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Obesity: Being overweight or obese can increase the risk of CHD due to the strain on the heart and the increased likelihood of developing other risk factors such as high blood pressure and high cholesterol.
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Sedentary Lifestyle: Lack of regular physical activity can increase the risk of CHD as it contributes to obesity, high blood pressure, and high cholesterol.
PEDIATRIC HEART SURGERIES
- The Mission Hospital , Durgapur is one of the high volume centre in the country to deal with complex congenital heart surgeries.
- The pioneering works being ROSS procedure, Pulmonary Root trans location and Truncal rotation.
- Excellent results with neonatal cardiac surgeries with TAPVC repair, Arterial switch Operation and TOF repair.
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World standard operations in ASD, VSD, TOF, BD Glenn Shunt operations.
STATE OF ART ITU (INTENSIVE THORACIC UNIT)
- 30 bedded ITU for the pre and post operative critical patients, well equipped with cardiac critical care specialist doctors, nursing staffs, technicians and physiotherapist.
- In house ABG facility, 24hr ECHO facility with ultramodern ventilators and multipara monitors.
ADULT CHD(ACHD) CLINIC
- Many newly diagnosed adult patients are getting treatment at our ACHD clinic in form of Device closures, open heart surgeries, medical management, dietary modifications, precautions during child bearing, safe delivery in CHD mothers etc.
- Regular follow-up for post operative adult patients