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Paediatric Pulmonology and Allergology
2008 April, Vol. XI, No. 1 (3805-3821)
LONG-TERM CARDIO-RESPIRATORY CONSEQUENCES OF HEART DISEASE IN CHILDHOOD
Dominic Fitzgerald1,2,*, Megan Sherwood3
1 Department of Paediatrics and Child Health, University of Sydney, Sydney, Australia;2 Department of Respiratory Medicine, Children’s Hospital at Westmead, Sydney, Australia;3 Adolph Basser Institute of Cardiology, Children’s Hospital at Westmead, Sydney, Australia
The dynamic interaction between the heart and lungs leads to a degree of respiratory comorbidity including both restrictive and obstructive airway abnormalities, which may be overlooked in children with congenital and acquired heart disease. The improving imaging techniques of the heart, both foetal and post-natal coupled with minimally invasive techniques for device implantation and better operative techniques for complex congenital heart disease have resulted in more children with longitudinally documented structural heart disease surviving into their adult years. In article single childhood heart diseases (congenital heart diseases, arrhytmias, Kawasaki disease, cardiomyopathies), influence on pulmonary function and exercise capacities are reviewed. In single section sudden cardiac death and its risk in cardiac disease is analysed. Children presenting with cardiomyopathy or arrhythmias, as well as those with repaired cardiac disease, can be offered advice with regard to formal exercise testing and participation in sports, which may be particularly helpful in the adolescent years. Therefore in this article exercise recommendations for young people with cardiac disease depend on cardiac disease, surgical procedure and residual symptoms after procedure are proposed. Furthermore, over the past 20–30 years, an interested group of adult cardiologists, like adult respiratory physicians, have developed expertise to assume care of young people with chronic disease. Transition is an orchestrated transfer of care, usually at the end of secondary schooling, which reflects the growing independence of the individual and resulting responsibility for one’s own health (Paediatric Respiratory Reviews 2007; 8: 313–22, translation and publication with permission).