Avaliação ecocardiográfica em crianças com fenda oral, para estudo de ocorrência de cardiopatia

Abstract

Objective: The present study aims to describe the clinical, electrocardiographic, and echocardiographic cardiologic findings in a group of patients with oral clefts (OC). Methods: Analysis of the clinical evaluation data (by a single pediatric cardiologist) and complementary examinations, by intra-method methodological triangulation, of patients with OC attended in the Multidisciplinary Care Program for Patients with Oral Clefts, University Hospital Onofre Lopes (HUOL). Patients were evaluated for age, sex, type of oral cleft, clinical signs of probability of heart disease (complaints, comorbidities, personal and family history) and electrocardiographic findings. Results: Seventy patients were included. Age range varied from neonate to adolescents (13 days of life to 19 years of age, mean of 4.64 years); 42 (60.0%) were male and 40 (57.2%) of the patients presented with lip and palate cleft. Twenty-eight (40.0%) patients presented health complaints at the time of consultation with a pediatric cardiologist and comorbidities were present in 31 (44.3%) patients. Relevant pregnancy, neonatal, family and personal antecedents were present in 39 (55.7%), 19 (27.1%), 47 (67.2%), and 17 (24.3%) of the patients, respectively. Regarding family history, the most frequent were Arterial Hypertension (20 / 20,0%), Dyslipidemia (17 / 17,0%) and Diabetes mellitus (12 / 12,0%); and personal, respiratory (12 / 52.2%) and heart diseases (2 / 8.7%). Electrocardiographic evaluation showed one case of atrioventricular block. The echocardiogram was normal in 45 (64.3%) and abnormal in 25 (35.7%) of the exams, including 05 cases of mitral valve prolapse (MVP)—one of them diagnosed with rheumatic heart disease (RHD). Conclusions: Our findings highlight the importance of the anamnesis with attention to personal and family risk factors, as well as, routine cardiological evaluation by fetal echocardiogram and methodological triangulation (clinical-electrocardiographic-echocardiographic) in the investigation of patients with OC. That strategy would permit the tracking of congenital heart diseases, cardiac rhythm alteration and prevention of acquired heart diseases. Moreover, it would contribute to comorbidity prevention and individualized planned treatment. The significant presence of MVP in this population may indicate increased risk for RHD in subjects with OC and highlight the need of more specific studies about this theme