Heart defects

Additional studies of the Woburn population have been completed (MDPH 1994). The final report indicated that there was an increased prevalence in choanal atresia, a rare respiratory effect, and hypospadias/congenital chordee. A small increase in eye defects was observed, but there was no association between TCE exposure and heart defects. There was no statistically significant associations between exposure concentrations and birth defects, although analyses was limited by the small number of cases observed. Based on four cases in the Woburn population, a rate of 0.88 was observed in the exposed population, compared to rates of 0.11 and 0.13 in the Atlanta and California comparison populations, respectively. In a prospective study completed after well closure, the rate of choanal atresia was 0.88 (based on 1 case) in Woburn, 0.11 in the surrounding communities, and 0.2 and 0.13 in Atlanta and California, respectively. The study authors cautioned that their study did not rule out moderate increases in rates of the less common adverse reproductive outcomes. For these outcomes only large increases would have been detected. 

Arizona, was exposed to trichloroethylene in drinking water and had increased numbers of congenital heart defects (Goldberg et al. 1990). 

Eisenmenger s syndrome A congenital heart defect with an abnormal connection between systemic circulation and lung circulation. 

Mirex has considerable potential for chronic toxicity because it is only partly metabolized, is eliminated very slowly, and is accumulated in the fat, liver, and brain. The most common effects observed in small laboratory mammals fed mirex included weight loss, enlarged livers, altered liver enzyme metabolism, and reproductive failure. Mirex reportedly crossed placental membranes and accumulated in fetal tissues. Among the progeny of mirex-treated mammals, developmental abnormalities included cataracts, heart defects, scoliosis, and cleft palates (NAS 1978 Blus 1995). 

Completely repaired congenital heart defect with prosthetic material or device, whether placed by surgeiy or by catheter intervention, during the first 6 months after the procedure ... 

Edwards Syndrome This is a genetic disorder with 3 chromosomes in chromosome 18 due to an abnormality in the egg or sperm before conception. Most fetuses do not survive and about 50% die in utero, and of those born, only 5-10% survive beyond one year. Babies have abnormally shaped head and other physical characteristics. In addition, sufferers of Edwards syndrome have heart defects. 

Trisomy 13 (Patau syndrome, 47,XY,+13 47,XX,H 13) is seen in approximately 1 in 10,000 live births. More than 90% of conceptions are lost prenatally, and more than 90% of those who survive to term do not survive to 1 year of age. Common disease features include oral-facial clefts, microphthalmia (small eyes), renal defects, and polydactyly (extra fingers). Central nervous system malformations and heart defects are common and contribute to mortality. 

Many disease traits are either present or absent in the individual (e.g., cleft lip and/or palate, club foot, congenital heart defects, cancer, diabetes). These traits are also thought to correspond to the multifectorial model, but the distribution here refers to an underlying liability to develop disease. Expression of the disease occurs only when a specific threshold is reached (Fig H-5 2). For some multifactorial diseases, the threshold differs in males and females. 

This is now a routine part of prenatal care, and it will detect some malformations and genetic diseases (e.g., nearly aU cases of anencephaly, most cases of open spina bifida, some types of reduced stature conditions, many congenital heart defects). However, the sensitivity of ultrasound diagnosis is low for many conditions (e.g., Down syndrome), and it fails to detect many genetic and biochemical abnormalities. 

An increase in fetal heart defects was observed in mice after 12 days of repeated exposure in utero to 500ppm. °... 

Children Caverject is not indicated for use in newborns or children. However, alprostadil Prostin VR Pediatric) is used in newborns to maintain the patency of the ductus arteriosus in neonates with congenital heart defects. 

Nora JJ, Nora HA, Toews WH Lithium, Ebstein s anomaly, and other congenital heart defects. Lancet 2 594-595, 1974... 

PGEj (Alprostadil) is being used as IV infusion in infants with congenital heart defects, to maintain the patency of ductus arteriosus. 

Accutane is a member of a family of drugs called retinoids, which are related to vitamin A. It is approved to treat serious forms of acne. These painful and disfiguring forms of acne do not respond to other acne treatments. Accutane is very effective, but its use is associated with a number of risks including birth defects. Exposure of pregnant women can lead to birth defects such as facial malformations, heart defects, and mental retardation. 

The observed growth deficiencies are associated with an inability of the baby to catch up due to a slower than normal rate of development. Other infrequent outcomes include skeletal malformations such as deformed ribs and sternum, scoliosis, malformed digits, and microcephaly. Distinctive facial anomalies have been associated with a diagnosis of fetal alcohol syndrome small eye openings, epicanthal folds, failure of eyes to move in the same direction, short upturned nose, flat or absent groove between nose and upper lip, and thin upper lip. Visceral deformities may also be present heart defects, genital malformations, kidney, and urinary defects. 

Monochloromethane (Methyl chloride, CH Cl) produced heart defects in the offspring of pregnant mice exposed to the vapor at 500 and 750 ppm, hence it is viewed as a potential occupational teratogen (refs. 30 and 31a.b). In addition, male rats exposed to 1000 ppm methyl chloride by inhalation showed degeneration and atrophy of the seminiferous tubules (ref. 33) ... 

In 1988, the U.S. Food and Drag Administration estimated that Accutane, used as an antiacne medication, may have been reponsible for approximately 1000 birth defects in children bom to women taking the drug during the period of 1982 to 1986. The chemical name for Accutane is isoretinoin, and it is chemically related to retinoic acid, vitamin A, which likewise is teratogenic at excessive levels. Exposure of the fetus to Accutane over a period of only several days can result in birth defects such as severe facial malformations, heart defects, thymus defects, and mental retardation.13... 

Developmental toxicity has also been observed in animals exposed to other CDDs. These effects include heart defects in rats exposed to 2,7-DCDD (Schwetz et al. 1973) decreased thymic weight in rats exposed to 1,2,3,7,8-PCDD (Madsen and Larsen 1989) subcutaneous edema, decreased fetal growth, delayed ossification, dilated renal pelvis, and cleft palate in rats exposed to HxCDD (Schwetz et al. 

E. Congenital heart defects are the most common cause of congestive heart failure. 

Gata4 G296S, E359del Congenital Heart Defects Nature, 2003. 424(6947) p. 443-7. 

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