Heart disease in infancy.

UK : University of London, 1971.

1 encoded moving image (36 min.) : sound, black and white.

00:35:52

University of London

Unrestricted

CC-BY-NC

Creative Commons Attribution-Non-Commercial 2.0 UK: England & Wales

In English

Presented by Dr. Jane Somerville, Institute of Cardiology, University of London. Produced by Peter Bowen.

This video is one of around 310 titles, originally broadcast on Channel 7 of the ILEA closed-circuit television network, given to Wellcome Trust from the University of London Audio-Visual Centre shortly after it closed in the late 1980s. Although some of these programmes might now seem rather out-dated, they probably represent the largest and most diversified body of medical video produced in any British university at this time, and give a comprehensive and fascinating view of the state of medical and surgical research and practice in the 1970s and 1980s, thus constituting a contemporary medical-historical archive of great interest. The lectures mostly take place in a small and intimate studio setting and are often face-to-face. The lecturers use a wide variety of resources to illustrate their points, including film clips, slides, graphs, animated diagrams, charts and tables as well as 3-dimensional models and display boards with movable pieces. Some of the lecturers are telegenic while some are clearly less comfortable about being recorded; all are experts in their field and show great enthusiasm to share both the latest research and the historical context of their specialist areas.

Segment 1 Dr Somerville introduces the subject and says that congenital heart disease will be focussed on in the lecture. She gives some death rate statistics of infants with heart disease. A graph is seen, showing the number of children admitted to Great Ormond Street as acute cardiac emergencies. She then discusses how cardiac disease causes illness in the infant. She runs through three main problems of the heart: overfilling of the lungs with blood, obstruction and hypoxic problems. Time start: 00:00:00:00 Time end: 00:05:10:00 Length: 00:05:10:00

Segment 2 Somerville discusses the sort of lesions that cause heart failure. She also talks about how a doctor can recognise the signs of such defects. She says that heart murmurs may not be a true sign and to look for tachypnoea or tachycardia. Various symptoms are listed onscreen. A photograph of a boy's chest with signs of bulging is shown and she says that this is a good sign that something is wrong with the lungs. Another view of the boy's chest is shown and Dr Somerville discusses the shape. Time start: 00:05:10:00 Time end: 00:09:57:10 Length: 00:04:47:10

Segment 3 A chest x-ray is shown and Somerville points out affected areas and signs of pulmonary oedema. She then summarises the signs of pulmonary oedema in infants, as well as the causes of it. Lists of the signs and causes are shown onscreen. She also lists possible diagnostic clues in babies with 'stiff' lung or heart failure. Time start: 00:09:57:10 Time end: 00:14:03:01 Length: 00:04:05:16

Segment 4 Somerville talks about the symptom of bounding pulses, which can indicate truncus arteriosis. She talks more about how to diagnose different types of congenital heart disease. She mentions the signs of hypoplastic left heart syndrome. Next, she talks about treatment for heart problems. A chart shows the principles of treatment. Ideally, babies should be treated at specialised centres. They probably also need sedating and tube feeding. She also talks about temperature control and what drugs should be used. Time start: 00:14:03:01 Time end: 00:19:01:22 Length: 00:04:58:21

Segment 5 Next, Somerville talks about surgical treatment. She talks about using surgery to treat various heart defects and warns that a baby may have more than one lesion in the heart. A list of surgical possibilities to treat different defects is shown. Next, she mentions hypoxic heart disease and lists non-cardiac causes of neonatal cyanosis. She recommends a chest x-ray to make a diagnosis. She explains what causes 'blue baby' and the problem of transposition of the great arteries. A graph showing the number of cases of transposition and the average life duration of these cases is shown. Chest x-rays of two cases are shown. Time start: 00:19:01:22 Time end: 00:24:59:15 Length: 00:06:00:08

Segment 6 A diagram of transposition is shown and Somerville explains it. A chest x-ray is shown. She then discusses creating an atrial septal defect to treat it, and shows a chest x-ray of Bill Rashkind's procedure of pulling a balloon through the atrial septum. A graph showing the fall in death rate after introduction of this procedure is shown. Somerville next discusses how to diagnose transposition and lists symptoms. She also lists times when cyanotic heart disease in the infant requires help. She begins to discuss the lesion type Fallot's Tetralogy. Time start: 00:24:59:15 Time end: 00:30:06:01 Length: 00:05:07:11

Segment 7 A diagram of Fallot's Tetralogy is shown and Somerville explains what it is. An angiocardiogram is shown and she explains the image. A table is used to explain infundibular shut down. Next, Somerville talks about indications for surgical treatment and how to recognise what kind of lesion is occuring. A chest-xray is shown of a patient with pulmonary atresia and intact ventricular septum. Another x-ray is seen, showing tricuspid atresia. Finally, Somerville stresses that accurate diagnosis and immediate treatment are necessary for successful treatment of congenital heart disease in the infant. Time start: 00:30:06:01 Time end: 00:35:52:13 Length: 00:05:46:12