Large tonsils and adenoids in small children with cor pulmonale.

Ainger, Lorin E.

doi:10.1136/hrt.30.3.356

Cited by 71 publications

(16 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Importantly, Davies et al [3] reported a significant decrease in nocturnal systolic blood pressure (SBP) following treatment of OSA with nasal continuous positive airway pressure in a group of adults with hypertension compared to untreated matched control subjects. These associations have not yet been fully studied in the pediatric population but there are several earlier reports describing pulmonary hypertension, cardiorespiratory failure, coma, and even sudden death associated with adenotonsillar hypertrophy and upper airway obstruction in children [4][5][6] . More recently, Marcus et al [7] reported elevated diastolic BP during both wakefulness and sleep in a group of 41 children with OSA compared to a control group of 26 with primary snoring.…”

Section: Introductionmentioning

confidence: 99%

Hypertension and obstructive sleep apnea in Caucasian children

Kirk

Midgley²,

Giuffre³

et al. 2010

WJC

View full text Add to dashboard Cite

AIM:To evaluate the prevalence of hypertension and/or left ventricular hypertrophy (LVH) in children with a diagnosis of obstructive sleep apnea (OSA). METHODS:A cross-sectional case series of consecutive, otherwise healthy children aged > 4 years, with polysomnography-proven OSA [apnea hypopnea index (AHI) > 1.5/h] is described. Echocardiography was performed on all subjects and left ventricular mass was calculated. Study subjects underwent additional investigation with 24-h ambulatory blood pressure (BP) monitoring. RESULTS:Thirty children (21 males) were studied.Mean age was 8.9 years. Mean body mass index was 19.87 kg/cm 2 . Mean AHI was 14.3/h. 10/30 (33%) of the study population met criteria for pre-hypertension (n = 3) or masked hypertension (n = 7) based on standard ambulatory monitoring criteria. All 10 children had systolic hypertension throughout the night with 5 of these also having elevated daytime systolic readings. There was a relationship between AHI and BP showing an increase of 1.162 percentile units in mean diastolic night BP (age, gender and height specific) per unit increase in AHI (P = 0.018). There were no subjects with LVH and/ or right ventricular hypertrophy. CONCLUSION:In our population of otherwise healthy Caucasian children, there was a high prevalence of hypertension that would not have been identified using standard office/clinic protocols.

show abstract

Section: Introductionmentioning

confidence: 99%

Hypertension and obstructive sleep apnea in Caucasian children

Kirk

Midgley²,

Giuffre³

et al. 2010

WJC

View full text Add to dashboard Cite

show abstract

“…Paralelamente, a hipoxemia produz vasoconstrição pulmonar e, por conseguinte, aumento da pressão da artéria pulmonar, caracterizando a hipertensão pulmonar. Assim como já demonstrado por outros autores [2][3][4][5] , pudemos comprovar a hipertensão pulmonar com base fisiopatológica na hipertrofia adenoamigdaliana. Dessa forma, acreditamos que para pacientes com importante hipertrofia adenoamigdaliana e sintomatologia exuberante o ecocardiograma pode ser bastante útil na determinação da hipertensão pulmonar; especialmente por se tratar de um exame seguro, prático e não invasivo 8 .…”

Section: Discussionunclassified

Hipertensão pulmonar em pacientes com hipertrofia adenoamigdaliana

Sebusiani

Pignatari

Armínio

et al. 2003

Rev. Bras. Otorrinolaringol.

View full text Add to dashboard Cite

Apesar de a hipertrofia adenoamigdaliana ser uma moléstia reconhecida desde os primórdios, foi somente descrita como causadora de hipertensão pulmonar e cor pulmonale em 1965 por Menashe e Farrehi. Ainda são poucos os casos apresentados na literatura analisando a existência de hipertensão pulmonar em crianças com aumento do tecido adenoamigdaliano. OBJETIVO: Avaliar a prevalência de hipertensão pulmonar em crianças com hipertrofia adenoamigdaliana. FORMA DE ESTUDO: Coorte transversal. MATERIAL E MÉTODO: Foram avaliados 14 pacientes, com idade inferior a 15 anos, de ambos os sexos, com indicação formal para adenoamigdalectomia por hipertrofia adenoamigdaliana. Todos os pacientes foram submetidos à avaliação pré-operatória contendo: questionário, avaliação clínica otorrinolaringológica, Rx simples de cavum, vídeo-nasofibroscopia e ecocardiograma. RESULTADOS: Dos 14 pacientes analisados, um (7,14%) apresentou hipertensão pulmonar. CONCLUSÃO: Com base em nosso estudo, concluímos que a hipertrofia adenoamigdaliana está relacionada com o desenvolvimento de hipertensão pulmonar, sendo o ecocardiograma um exame bastante útil na determinação desta condição clínica. A remoção cirúrgica do tecido adenoamigdaliano pode reverter o quadro de hipertensão pulmonar decorrente do processo obstrutivo crônico.

show abstract

“…38 However, it is also possible that in many cases, OSAS is a major contributing factor considering that older studies described cor pulmonale secondary to OSAS in children with adenotonsillar hypertrophy. 39,40 Studies performed by Loughlin and Kasian relieved upper airway obstruction in children with DS by intubating them during cardiac catheterization, and were able to demonstrate temporary reversal of pulmonary hypertension. 41,42 In addition, Levine and Rowland reported other cases of DS and cor pulmonale reversed by relieving upper airway obstruction.…”

Section: Cardiovascular Implications Of Osas In Dsmentioning

confidence: 96%