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成人에서 본 先天性心臟病의 臨床的 觀察

CONGENITAL HEART DISEASES IN ADULTS

대한의학협회지 1964년 7권 12호 p.1151 ~ 1161
김수생,
소속 상세정보
김수생 (  ) - 경북대학교 의과대학 내과학교실

Abstract


Clinical data were reviewed on 70 cases of congenital heart disease in adults seen at the Department of Medicine, Kyungpook University Hospital, from January 1958 to August 1964. In addition, electro cardiograms of 131 cases of congenital heart disease in adults and children were analysed for the evaluation fiagnostic value of the mean frontral axis of QRS complan and correlation of electrocardiographic patterns of ventricular overloading with homodynarnic overloading of ventricles.
The incidence of congenital heart disease in adults were 0.07 per cent of total adult patients attended medical service during the same period and its ratio to rheumatic heart disease was approximately 1 :4.5. The peak incidence of congenital heart disease was found in the age group of 20-25 years, the overall male to female ratio in adult cases being5 : 2.
Among various types of congenital heart diseasethe cyanotic group was 14.3 per cent, and the cardinal lesions in order of frequency were atrialseptal defect, ventricular septal defect, patentductus arteriosus, pulmonic stenosis and tetralogy of Fallet, but coarctation of the aorta was found in less than two per cent of the cases.
Nine cases in the acyanotic group were asymptomatic and cyanosis was the chief complaint on admission in only 11 per cent of the cases in the cyanotic group. Frequent respiratory infections were thought to be not a serious problem in adults contrary to that in children.
In most of the cases. both in adults and children, mean frontal axes of QRS complexes were in the Bailey´s sextant V, in which atrial septal defect,ventricular septal defect, patent ductus arteriosus, pulmonic stenosis and tetralogy of Fallet were foundin order of frequency, and about six per cent of atrial septal defect and all of two cases with tricuspid atresia were in the sextant 1.
Correlation of electro cardioographic findings of ventricular overloading with hemodrnamic overloading was variable depending upon the types of overloading, and the overall compatibility between these wasonly 46.2 per cent. However, it was felt that final conclusion in this regard should be elaborated based upon analysis of a greater number of well studied cases, pathologically as well as physiologically.

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