From ECG to Imaging: Challenges in the Diagnosis of Adult Congenital Heart Diseases
Abstract
:1. Introduction
2. Atrial Septal Defect (ASD)
Atrial Septal Defect—Case Presentation
3. Ebstein’s Anomaly
Ebstein’s Anomaly—Case Presentation
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
- Hoffman, J.I.E.; Kaplan, S. The Incidence of Congenital Heart Disease. J. Am. Coll. Cardiol. 2002, 39, 1890–1900. [Google Scholar] [CrossRef] [PubMed]
- Yasuhara, J.; Garg, V. Genetics of Congenital Heart Disease: A Narrative Review of Recent Advances and Clinical Implications. Transl. Pediatr. 2021, 10, 2366–2386. [Google Scholar] [CrossRef]
- Williams, K.; Carson, J.; Lo, C. Genetics of Congenital Heart Disease. Biomolecules 2019, 9, 879. [Google Scholar] [CrossRef]
- Hartman, R.J.; Rasmussen, S.A.; Botto, L.D.; Riehle-Colarusso, T.; Martin, C.L.; Cragan, J.D.; Shin, M.; Correa, A. The Contribution of Chromosomal Abnormalities to Congenital Heart Defects: A Population-Based Study. Pediatr. Cardiol. 2011, 32, 1147–1157. [Google Scholar] [CrossRef]
- Brida, M.; Chessa, M.; Celermajer, D.; Li, W.; Geva, T.; Khairy, P.; Griselli, M.; Baumgartner, H.; Gatzoulis, M.A. Atrial Septal Defect in Adulthood: A New Paradigm for Congenital Heart Disease. Eur. Heart J. 2022, 43, 2660–2671. [Google Scholar] [CrossRef]
- Fuchs, M.M.; Connolly, H.M. Ebstein Anomaly in the Adult Patient. Cardiol. Clin. 2020, 38, 353–363. [Google Scholar] [CrossRef] [PubMed]
- Bradley, E.A.; Zaidi, A.N. Atrial Septal Defect. Cardiol. Clin. 2020, 38, 317–324. [Google Scholar] [CrossRef] [PubMed]
- Nashat, H.; Montanaro, C.; Li, W.; Kempny, A.; Wort, S.J.; Dimopoulos, K.; Gatzoulis, M.A.; Babu-Narayan, S.V. Atrial Septal Defects and Pulmonary Arterial Hypertension. J. Thorac. Dis. 2018, 10 (Suppl. 24), S2953–S2965. [Google Scholar] [CrossRef]
- Baumgartner, H.; De Backer, J.; Babu-Narayan, S.V.; Budts, W.; Chessa, M.; Diller, G.-P.; lung, B.; Kluin, J.; Lang, I.M.; Meijboom, F.; et al. 2020 ESC Guidelines for the Management of Adult Congenital Heart Disease: The Task Force for the Management of Adult Congenital Heart Disease of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Adult Congenital Heart Disease (ISACHD). Eur. Heart J. 2021, 42, 563–645. [Google Scholar] [CrossRef]
- Krasemann, T.; van Osch-Gevers, L.; van de Woestijne, P. Cyanosis Due to an Isolated Atrial Septal Defect: Case Report and Review of the Literature. Cardiol. Young 2020, 30, 1741–1743. [Google Scholar] [CrossRef]
- Theodoropoulos, K.C.; Papachristidis, A.; Masoero, G.; Papitsas, M.; Cospite, V.; Avci Demir, F.; Sado, D.M.; Monaghan, M.J. Superior Sinus Venosus Atrial Septal Defect. J. Geriatr. Cardiol. 2018, 15, 649–652. [Google Scholar] [CrossRef] [PubMed]
- Quadros, S.D.-R.; Pavithran, S.; Agrawal, R.; Sivakumar, K. Coronary Sinus Atrial Septal Defect without Persistent Left Superior Vena Cava: Three-Dimensional Imaging of a Rare Defect. Ann. Pediatr. Cardiol. 2018, 11, 103–105. [Google Scholar] [CrossRef]
- Sagar, P.; Sivakumar, K.; Chandrasekaran, R.; Pavithran, S.; Thejaswi, P.; Monica, R. Transcatheter Closure of Multiple Secundum Atrial Septal Defects Using Multiple Occluder Devices: A Comparative Experience between Pediatric and Adult Patients. Ann. Pediatr. Cardiol. 2022, 15, 128–137. [Google Scholar] [CrossRef]
- Martin, S.S.; Shapiro, E.P.; Mukherjee, M. Atrial Septal Defects—Clinical Manifestations, Echo Assessment, and Intervention. Clin. Med. Insights Cardiol. 2014, 8, CMC.S15715. [Google Scholar] [CrossRef]
- Bannan, A.; Shen, R.; Silvestry, F.E.; Herrmann, H.C. Characteristics of Adult Patients with Atrial Septal Defects Presenting with Paradoxical Embolism. Catheter. Cardiovasc. Interv. 2009, 74, 1066–1069. [Google Scholar] [CrossRef] [PubMed]
- Rocha, D.F.R.; Guimarães, H.L.; Lopes, M.P.; Silva, J.B.M.; Gardenghi, G. Percutaneous Closure of Multiple Atrial Septal Defects with Hemodynamic Repercussions: Report of Two Cases in First-Degree Related Adult Patients. Arq. Bras. Cardiol. 2022, 35, eabc345. [Google Scholar] [CrossRef]
- Rigatelli, G.; Zuin, M.; Roncon, L.; Nanjiundappa, A. Secundum Atrial Septal Defects Transcatheter Closure versus Surgery in Adulthood: A 2000-2020 Systematic Review and Meta-Analysis of Intrahospital Outcomes. Cardiol. Young 2021, 31, 1–6. [Google Scholar] [CrossRef]
- Li, Y.; Zhou, K.; Hua, Y.; Wang, C.; Xie, L.; Fang, J.; Rong, X.; Shen, J. Amplatzer Occluder versus CardioSEAL/STARFlex Occluder: A Meta-Analysis of the Efficacy and Safety of Transcatheter Occlusion for Patent Foramen Ovale and Atrial Septal Defect. Cardiol. Young 2013, 23, 582–596. [Google Scholar] [CrossRef]
- Galea, J.; Ellul, S.; Schembri, A.; Schembri-Wismayer, P.; Calleja-Agius, J. Ebstein Anomaly: A Review. Neonatal Netw. 2014, 33, 268–274. [Google Scholar] [CrossRef]
- Lamers, W.H.; Virágh, S.; Wessels, A.; Moorman, A.F.; Anderson, R.H. Formation of the Tricuspid Valve in the Human Heart. Circulation 1995, 91, 111–121. [Google Scholar] [CrossRef] [PubMed]
- Holst, K.A.; Connolly, H.M.; Dearani, J.A. Ebstein’s Anomaly. Methodist. Debakey Cardiovasc. J. 2019, 15, 138–144. [Google Scholar] [CrossRef] [PubMed]
- Sainathan, S.; da Fonseca da Silva, L.; da Silva, J.P. Ebstein’s Anomaly: Contemporary Management Strategies. J. Thorac. Dis. 2020, 12, 1161–1173. [Google Scholar] [CrossRef] [PubMed]
- Anderson, K.R.; Zuberbuhler, J.R.; Anderson, R.H.; Becker, A.E.; Lie, J.T. Morphologic Spectrum of Ebstein’s Anomaly of the Heart: A Review. Mayo Clin. Proc. 1979, 54, 174–180. [Google Scholar]
- Dearani, J.A.; Mora, B.N.; Nelson, T.J.; Haile, D.T.; O’Leary, P.W. Ebstein Anomaly Review: What’s Now, What’s Next? Expert. Rev. Cardiovasc. Ther. 2015, 13, 1101–1109. [Google Scholar] [CrossRef] [PubMed]
- Stephens, E.H.; Dearani, J.A.; Qureshi, M.Y.; Ammash, N.; Maleszewski, J.J. The Congenital Tricuspid Valve Spectrum: From Ebstein to Dysplasia. World J. Pediatr. Congenit. Heart Surg. 2020, 11, 783–791. [Google Scholar] [CrossRef]
- Gerlis, L.M.; Ho, S.Y.; Sweeney, A.E. Mitral Valve Anomalies Associated with Ebstein’s Malformation of the Tricuspid Valve. Am. J. Cardiovasc. Pathol. 1993, 4, 294–301. [Google Scholar] [PubMed]
- Walsh, E.P. Ebstein’s Anomaly of the Tricuspid Valve: A Natural Laboratory for Re-Entrant Tachycardias. JACC Clin. Electrophysiol. 2018, 4, 1271–1288. [Google Scholar] [CrossRef]
- Yuan, S.-M. Ebstein’s Anomaly: Genetics, Clinical Manifestations, and Management. Pediatr. Neonatol. 2017, 58, 211–215. [Google Scholar] [CrossRef]
- Zimmer, E.; Blazer, S.; Lorber, A.; Solt, I.; Egenburg, S.; Moshe, B. Fetal Ebstein’s Anomaly: Early and Late Appearance. Prenat. Diagn. 2012, 32, 228–233. [Google Scholar] [CrossRef]
- Kapusta, L.; Eveleigh, R.M.; Poulino, S.E.; Rijlaarsdam, M.E.; du Marchie Sarvaas, G.J.; Strengers, J.L.; Delhaas, T.; de Korte, C.L.; Feuth, T.; Helbing, W.A. Ebstein’s Anomaly: Factors Associated with Death in Childhood and Adolescence: A Multi-Centre, Long-Term Study. Eur. Heart J. 2007, 28, 2661–2666. [Google Scholar] [CrossRef]
- Acharya, P.; Ang, J.R.; Gitler, B. Ebstein Anomaly with QRS Fragmentation on Electrocardiogram. J. Investig. Med. High. Impact Case Rep. 2017, 5, 2324709616688710. [Google Scholar] [CrossRef] [PubMed]
- Dalakoti, M.; Singh, D.; Yeo, W.T.; Tay, L.W.E.; Poh, K.K. Electrocardiography Findings and Clinical Presentation in Ebstein’s Anomaly. Singap. Med. J. 2019, 60, 560–565. [Google Scholar] [CrossRef] [PubMed]
- Lara de Melo, S.; Rosa, X.F.; Pisani, C.F.; Lopes, H.B.; Chokr, M.O.; Scanavacca, M.I. Differential Diagnosis and Treatment of Wide QRS Tachycardia in an Ebstein Anomaly Patient. Hear. Case Rep. 2021, 7, 369–373. [Google Scholar] [CrossRef]
- Sharma, T.; Habash, F.; Mounsey, J.; Baker, C.; Lopez Candales, A. Ebstein’s Anomaly in Disguise: Follow the Cues and the Diagnosis Can Be Made. Cureus 2020, 12, e10773. [Google Scholar] [CrossRef]
- Oechslin, E.; Buchholz, S.; Jenni, R. Ebstein’s Anomaly in Adults: Doppler-Echocardiographic Evaluation. Thorac. Cardiovasc. Surg. 2000, 48, 209–213. [Google Scholar] [CrossRef] [PubMed]
- Kossaify, A. Echocardiographic Assessment of the Right Ventricle, from the Conventional Approach to Speckle Tracking and Three-Dimensional Imaging, and Insights into the “Right Way” to Explore the Forgotten Chamber. Clin. Med. Insights Cardiol. 2015, 9, 65–75. [Google Scholar] [CrossRef]
- Zaidi, A.; Oxborough, D.; Augustine, D.X.; Bedair, R.; Harkness, A.; Rana, B.; Robinson, S.; Badano, L.P. Echocardiographic Assessment of the Tricuspid and Pulmonary Valves: A Practical Guideline from the British Society of Echocardiography. Echo Res. Pr. 2020, 7, G95–G122. [Google Scholar] [CrossRef]
- Ibrahim, E.A.; Abdelhady, Y.M.; Helmy, I.M.; Reffat, M.M.; Mahrous, M.R. Role of Magnetic Imaging Resonance Imaging in Ebstein Anomaly. Benha Med. J. 2022, 39, 37–54. [Google Scholar] [CrossRef]
- Mochula, O.; Troshkinev, N.; Krivoshchekov, E.; Ussov, W. Cardiac Magnetic Resonance Imaging in Assessing Heart Function in Patients with Ebstein’s Anomaly. Eur. Heart J. 2021, 42 (Suppl. 1), ehab724.0243. [Google Scholar] [CrossRef]
- Yalonetsky, S.; Tobler, D.; Greutmann, M.; Crean, A.M.; Wintersperger, B.J.; Nguyen, E.T.; Oechslin, E.N.; Silversides, C.K.; Wald, R.M. Cardiac Magnetic Resonance Imaging and the Assessment of Ebstein Anomaly in Adults. Am. J. Cardiol. 2011, 107, 767–773. [Google Scholar] [CrossRef] [PubMed]
- Walsh, E.P.; Cecchin, F. Arrhythmias in Adult Patients with Congenital Heart Disease. Circulation 2007, 115, 534–545. [Google Scholar] [CrossRef] [PubMed]
- Homzova, L.; Photiadis, J.; Sinzobahamvya, N.; Ovroutski, S.; Cho, M.-Y.; Schulz, A. Surgical Management of Ebstein Anomaly: Impact of the Adult Congenital Heart Disease Anatomical and Physiological Classifications. Interact. Cardiovasc. Thorac. Surg. 2020, 32, 593–600. [Google Scholar] [CrossRef]
- Stulak, J.M.; Dearani, J.A.; Danielson, G.K. Surgical Management of Ebstein’s Anomaly. Semin. Thorac. Cardiovasc. Surg. Pediatr. Card. Surg. Annu. 2007, 10, 105–111. [Google Scholar] [CrossRef] [PubMed]
- Da Silva, J.P.; Viegas, M.; Castro-Medina, M.; Da Fonseca Da Silva, L. The Da Silva Cone Operation after the Starnes Procedure for Ebstein’s Anomaly: New Surgical Strategy and Initial Results. JTCVS Tech. 2020, 3, 281–283. [Google Scholar] [CrossRef]
- Danielson, G.K.; Fuster, V. Surgical Repair of Ebstein’s Anomaly. Ann. Surg. 1982, 196, 499–504. [Google Scholar] [CrossRef] [PubMed]
- Li, B.; Sun, H.-S.; Pan, S.-W.; Xu, J.-P. Outcomes of Ebstein’s Anomaly Patients Treated with Tricuspid Valvuloplasty or Tricuspid Valve Replacement: Experience of a Single Center. Chin. Med. J. 2018, 131, 1067–1074. [Google Scholar] [CrossRef] [PubMed]
- Eckerström, F.; Dellborg, M.; Hjortdal, V.E.; Eriksson, P.; Mandalenakis, Z. Mortality in Patients with Ebstein Anomaly. J. Am. Coll. Cardiol. 2023, 81, 2420–2430. [Google Scholar] [CrossRef] [PubMed]
- Mosoiu, D.; Rogozea, L.; Landon, A.; Bisoc, A.; Tint, D. Palliative Care in Heart Failure: A Public Health Emergency. Am. J. Ther. 2020, 27, e204–e223. [Google Scholar] [CrossRef]
- Attenhofer Jost, C.H.; Schmidt, D.; Huebler, M.; Balmer, C.; Noll, G.; Caduff, R.; Greutmann, M. Heart Transplantation in Congenital Heart Disease: In Whom to Consider and When? J. Transpl. 2013, 2013, 376027. [Google Scholar] [CrossRef]
- Karakasis, P.; Giannakoulas, G.; Theofilis, P.; Patoulias, D.; Fragakis, N. Direct Oral Anticoagulants or Vitamin K Antagonists in Adult Patients with Congenital Heart Disease? Eur. J. Intern. Med. 2024; ahead of print. [Google Scholar] [CrossRef]
- Dong, W.; Hong, Z.; Wang, A.; Jiang, K.; Zhu, H.; Zhang, F.; Guo, Z.; Su, H.; Cao, Y. Risk Stratification and Prognosis of Pulmonary Arterial Hypertension Associated with Congenital Heart Disease. Congenit. Heart Dis. 2024, 19, 325–339. [Google Scholar] [CrossRef]
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Crișan, S.; Băghină, R.-M.; Luca, S.; Pătru, O.; Lazăr, M.-A.; Văcărescu, C.; Rus, M.; Cozma, D.; Gaiță, D.; Luca, C.-T. From ECG to Imaging: Challenges in the Diagnosis of Adult Congenital Heart Diseases. J. Clin. Med. 2024, 13, 4865. https://doi.org/10.3390/jcm13164865
Crișan S, Băghină R-M, Luca S, Pătru O, Lazăr M-A, Văcărescu C, Rus M, Cozma D, Gaiță D, Luca C-T. From ECG to Imaging: Challenges in the Diagnosis of Adult Congenital Heart Diseases. Journal of Clinical Medicine. 2024; 13(16):4865. https://doi.org/10.3390/jcm13164865
Chicago/Turabian StyleCrișan, Simina, Ruxandra-Maria Băghină, Silvia Luca, Oana Pătru, Mihai-Andrei Lazăr, Cristina Văcărescu, Marius Rus, Dragoș Cozma, Dan Gaiță, and Constantin-Tudor Luca. 2024. "From ECG to Imaging: Challenges in the Diagnosis of Adult Congenital Heart Diseases" Journal of Clinical Medicine 13, no. 16: 4865. https://doi.org/10.3390/jcm13164865