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Clinical study on the factors used in the diagnosis of heart failure.

Journal of the Korean Pediatric Society 1991;34(11):1534-1539.
Published online November 30, 1991.
Clinical study on the factors used in the diagnosis of heart failure.
Dong Chul Park, Seok Min Choi, Jun Hee Sul, Sung Kyu Lee, Dong Shik Chin
Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea
단순 심실중격결손증 환아에서 심부전증의 진단에 이용된 인자분석
박동철, 최석민, 설준희, 이승규, 진동식
연세대학교 의과대학 소아과학교실
Received: 10 June 1991   • Accepted: 4 July 1991
Heart failure is the state in which heart cannot produce the cardiac output required to sustain the metabolic needs of the body without evoking certain compensatory mechanisms. As these mecha- nisms become ineffective, increasingly severe clinical manifestations result. The diagnosis of conges- tive heart failure relies on several sources of clinical findings, including history, physical examination, and chest X-rays. For lack of uniform diagnostic criteria,heart failure is a clinical diagnosis based on clinical judgement. The author made observations on history, physical examination and laboratory findings of patients with isolated ventricular septal defect under the age of 15 years, who had been admitted and treated surgically at Severance Hospital from Jan 1984 to Dec 1988. Of 252 cases of isolated ventricular septal defects, heart failure was present in 27cases (10.8%). In infancy, clinical manifestations were not different between two groups. In childhood, growth retardation and perspiration were more common in the heart failure group than in control group (p<0.05). Hepatomegaly, increased pulmonary vasculature and cardiomegaly on the chest X-rays were more common in the heart failure group (p< 0.05). Among cardiac catheterization findings, only Rp/Rs was significantly higher in the heart failure group. The sizes of septal defects per body surface area were larger in the heart failure group (437.15±293.63 mm2) than in control group (320.39±423.54 mm2) but was statistically insignificant. Considering a poor correlation between clinical diagnosis and the size of septal defects or pulmo- nary blood flow which are thought to be directly related to the development of heart failure, uniform diagnostic criteria of heart failure is necessary for accurate diagnosis of congestive heart failure and evaluation of treatment for congestive heart failure in pediatric age group.
Key Words: Ventricular Septal Defect, Heart Failure

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