Folia Medica Indonesiana
ISSN 0303-7932
Vol. 45 / No. 2 / Published : 2009-04
Order : 10, and page :145 - 154
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Original Article :
Review article : congenital heart disease. the holistic approach, now and in the future in indonesia
Author :
- Teddy Ontoseno*1
- Cardiology Division, Department of Child Health Dr. Soetomo Teaching Hospital Airlangga University School of Medicine
Abstract :
Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in basic to clinical approach, treatment and drug therapy are required. Health and Medicine emphasizes holistic approaches to understanding and preventing disease. A wide range of health care interventions is explored. Congenital heart disease (CHD) is cardiovascular malformations are generally the result of aberrant development of a normal structure in the fetus, or failure of such a structure to progress beyond an early stage of embryonic or fetal development. Malformations are due to complex multifactor genetic and environmental causes. The only possible definitive treatment is cardiac corrective surgery. Now, in Indonesia, this procedure remains less accessible, so that a large proportion (95%) of CHD patients have no opportunity to undergo operation, subjecting those patients to the risk of fatal complications and chronic stress. Although human genetic approaches are important in understanding of the etiology of congenital heart disease (CHD), detailed molecular analysis of cardiac development in human is difficult. Recently, researchers have begun to clarify how stress may contribute to these pregnancy outcomes. High levels of stress were more likely to have high levels of a hormone called corticotrophin-releasing hormone (CRH) in their blood. This and other studies have found a link between high levels of CRH and preterm labor or congenital hear defect of the baby. A thoughtful and rational holistic approach to the prevention of the occurrence of CHD, and differential diagnosis is important for prompt recognition and appropriate management. It is imperative that a concerted team approach involving psychiatrist, geneticist, neonatologist, cardiologist, nurse, surgeon, and anesthesiologist is utilized. This paper suggests that psychoneuroimmunology may have broad implications for the basic biological sciences and medicine in CHD.
Keyword :
congenital heart disease, psychoneuroimmunology , holistic approach,
References :
Artman M, Mahony L, Teitel DF,(2002) Prenatal Evaluation and Management. In : Neonatal Cardiology - : The McGraw-Hill Companies
Anderson RH, Macartney FJ, Shinebourne EA and Tynan M,(1987) Fetal circulation and circulatory changes at birth. In : Anderson RH, Macartney FJ, Shinebourne EA and Tynan M, eds. Paediatric Cardiology. Vol.2 - : Churchill Livingstone
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