Dr. Babar Hasan speaks on Myths of Acyanotic Heart Disease

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 Lecture series at Jinnah Medical and Dental College

Dr. Babar Hasan speaks on Myths
of Acyanotic Heart Disease

KARACHI: Dr. Babar Hasan, MD FAAP, Consultant Paediatric Cardiologist at Aga Khan University Hospital was the guest speaker at the lecture series started by Jinnah Medical and Dental College at its campus on February 15, 2014. The topic of his presentation was myths of Acyanotic heart disease wherein he discussed at length the physiology and management of the patients suffering from congenital heart diseases. Every year about sixty five, he said, are not picked up early and treated hence they might present to the physicians at a later stage in adult age. The four most important lesions which he mentioned included ASD, VSD, PDA and AP window. Tetrology of Fallot, he opined, may also present as an Acyanotic heart lesion in some patients.
Lungs and heart, he said, are going to be affected the most with Acyanotic heart disease. It is the volume overloading lesion. When the lungs have developed long term changes, some of these patients are gong to present later in life with pulmonary vascular obstructive disease. It is the atrial pressure and size of defect which is going to determine the pressure in ASD. These patients will have more symptoms during exercise. Large exertion dysenea patients will come at the age of 20-25 years while PVOD will come much later. He also discussed about the treatment of severe pulmonary arterial hypertension and pointed out that oxygen is the most potent pulmonary vasodilator. Medications may work for few weeks but the hole has to be closed. Some of these patients who suffer from congenital heart diseases lesions are treated as pneumonia, he added.
Congestive Heart Disease, he pointed out is the inability of the heart to do the required job which is pump failure. Speaking about shunt dependent oxygen therapy, he said that one should limit O2 therapy for cyanosis. Maintain SATS at 75-85%, it can drop significantly. He also pointed out that almost 40% of previously diagnosed congenital heart disease patients awaiting correction who presented to Emergency Room at AKU were admitted to Paediatric Intensive Care Unit and almost 59% of those admitted to PICU expired. His message was the we should follow strict criteria to diagnose pneumonia in shunted lesions and one should not forget about SVR. He then briefly talked about assessment of patient in acute decompensated heart failure. Warm and wet patients, he pointed out just need diuretics to bring them back to category A where they are warm and dry. Patients in cold and dry category are severely dehydrated.
Participating in the discussion Dr.Adnan Director Medicare Heart emphasized the importance of early detection of congenital heart disease which is the key. It is absolutely criminal if we miss them at an early age and then they present for correction much later, he added.
Earlier Prof. H.R. Ahmad introduced the guest speaker while Dr. Ayaz Shaikh, Dy. Director Medicare Heart thanked the speaker at the end of the session.

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