Abstract
BackgroundCongenital space-occupying thoracic malformations and diaphragmatic hernia have in common pulmonary hypoplasia. Our study aims to assess cardiac involvement during post-natal adaptation.MethodsA retrospective study was carried out on newborns with prenatally diagnosed intrathoracic mass. Gathering for respiratory distress syndrome (RDS), 35 neonates were compared for clinical course, cardiovascular enzymes, ECG, and ultrasound.ResultsThe analysis revealed a high left heart defect rate in patients with severe RDS, without being influenced by the laterality. Ultrasound or laboratory assessment did not detect altered cardiac dimension or cardiomyopathy. Solely ECG signs of right ventricular strain were found. Increased QT-dispersion, T-wave and cardiac variability alterations in the first hours were all expression of non-specific cardiac repolarization disorders but predict worse outcome.ConclusionsAlthough RDS is the predominant symptom, slight cardiac dysfunctions should be recognized for prompt treatment. Conventional examinations for postnatal adaption should be integrated by complementary investigations.
Highlights
Congenital space-occupying thoracic malformations and diaphragmatic hernia have in common pulmonary hypoplasia
Multiple malformations can occur in the same patient implicating a common embryopathogenesis [5,6,7,8,9,10,11,12]
Perinatal characteristics were not significantly different in the malformation groups, but they differed in the respiratory distress syndrome (RDS) severity-gathering (Table 1)
Summary
Congenital space-occupying thoracic malformations and diaphragmatic hernia have in common pulmonary hypoplasia. Rare space-occupying thoracic malformations such as congenital cystic adenomatoid malformation (CCAM; incidence 0.11‰ live births) [1], pulmonary sequestration complex, congenital lobar emphysema, bronchial atresia, foregut duplication cysts, and chest tumors, must be differentiated from displaced abdominal organs due to congenital diaphragmatic hernia (CDH; incidence 0.28‰ live births) [1]. All these conditions must be evaluated for concomitant congenital pulmonary hypoplasia (congenital small lung) [2,3,4]. Mortality rate resulting from CCAM with associated early hydrops and without intervention or maternal betamethasone administration can reach
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