title: Evaluation of Congenital Valvular Heart Diseases by the Pediatrician: When to Follow, When to Refer for Intervention?
abstract: Isolated congenital valvular heart disease in children constitutes a small fraction of congenital heart diseases. Valve involvement is seen more along with other congenital diseases. The most commonly involved valve is the pulmonary valve followed by the aortic valve. Stenotic lesions of the pulmonary and aortic valves are more frequently encountered than mitral and tricuspid valvular lesions. The presentation depends on the severity of the lesion and the age of the patient. Symptoms range from asymptomatic status to florid symptoms of valve obstruction and/or leak. Detailed clinical assessment and various imaging techniques confirm the diagnosis and help in management planning. Transcatheter balloon dilatation for obstructive pulmonary valve has very good long-term outcomes. The results of balloon dilation of aortic valve are also good enough for it to be the treatment of choice. Significant lesions of the mitral and tricuspid valve, regurgitant lesions, sub and supra valvular obstructions require surgical correction. Most valvar lesions mandate regular follow up. Communication and coordination between the pediatric cardiologist and the pediatrician helps in the optimal management.
authors.affiliation: Department of Pediatric Cardiology, The Madras Medical Mission, Mogappair, Chennai, India.
authors.forename: Anil Kumar
authors.initials: AK
authors.lastname: Singhi
authors.affiliation: Department of Pediatric Cardiology, Amrita Institute of Medical Sciences and Research Center, Ponekkara PO, Cochin, 682041, Kerala, India. kumar_rk@yahoo.com.
authors.forename: Raman Krishna
authors.initials: RK
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000792:Angiography; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006349:Heart Valve Diseases / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D000072143:Pediatricians; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation
keywords: Catheter intervention; Congenital valvular disease; Follow-up