Day 3: 8th Biennial Convention in Review

by: Dr. Rogelyn T. Olais

DAY 3 of PSPC Biennial Convention is done. And, it was another day packed with learning that kicked off with the plenary lecture entitled “State of the Heart: Multimodality Imaging of Congenital Heart Diseases” by DR. JUSTINE IRIS C. YAP.  With her training here and abroad, she discussed the high end technology for CHD in this millennium – 3D echo, 4D echo, TEE, CT and CMR.

“Multimodality imaging involves anatomists/morphologists and cardiologists with interests in various imaging modalities which can improve communication and collaborative work among imaging lab or heart institutions. There are guidelines for this approach that aims to provide the most appropriate and cost-effective diagnostic pathway for each patient with congenital heart disease”.

Every imaging modality has its strengths and weaknesses and indications and contraindications. So, being the pediatric cardiologist, we choose what diagnostic tool or tools is/are best for our patient. It will always start with history, examination, EKG, chest radiograph and Transthoracic 2D echocardiogram. It may end with TTE if anatomic and physiological evaluation is complete for clinical decision making. If not, there is an array of other imaging modalities depending on the need as shown in this picture.

The next lecture for DAY 3 was entitled “Helping your Patient Live Fully with Pulmonary Arterial Hypertension: Preoperative and Postoperative Strategies” delivered by DR. JHULIET J. BALDERAS. PAH was lectured in toto- its definition,  pathogenesis, modified classification, progression to Eisenmenger syndrome, management including Bosentan administration.

DAY 3 was wrapped up by an exciting panel discussion “Team Huddle: Multi-Specialty Approach to a Challenging Cardiac Case”. The case of Infective Endocarditis, Embolic Stroke in a TOF patient was dissected by DR. JAMES L. ANGTUACO, a pediatric cardiologist, DR. FATIMA I. GIMENEZ, a pediatric infectious specialist and  DR. AMPARO C. AGRAVA, a pediatric neurologist.

Some key points from the case – 1) Strep viridans is still the most common cause of IE, 2) treat IE with intravenous antibiotics for at least 4 weeks. There is really no shortcut; 3) aside from meticulous neuro PE, an initial cranial CT scan is warranted to assess Neuro status and 4) overemphasis to dental hygiene at least 2x a year and immunization to prevent IE/recurrence.