Internal Medicine

0521779407-18 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 8:1

Repaired Congenital Heart Disease Restless Legs Syndrome 1295

complications and prognosis

Complications

■Endocarditis

■Transposition and tetralogy repairs

➣Right heart failure due to volume overload or pulmonary hyper-

tension

➣Stenosis/thrombosis of palliative shunts or conduits

➣Atrial and ventricular arrhythmias

➣Sudden cardiac death

➣Residual VSD

➣Systemic (tricuspid valve) regurgitation (transposition repairs)

■Coarctation repairs

➣Recurrence of HTN

➣Aortic dissection

➣Premature CAD

Prognosis

■Tetralogy of Fallot (94% 25-year survival if repaired early)

■Transposition of great arteries (90% 20-year survival)

■Coarctation (91% 20-year survival if repaired before age 14)

RESTLESS LEGS SYNDROME

CHAD CHRISTINE, MD

history & physical

■Tightness, tingling or burning discomfort in legs

■Exacerbated by rest; relief w/ activity

■Symptoms involve rhythmic movement of feet during sleep that dis-

turbs sleep

■Hereditary

■Signs: unremarkable

tests

■Lab tests & neuroimaging are unremarkable

■Sleep study may demonstrate periodic limb movements & frequent

arousals

differential diagnosis

■Polyneuropathy, radiculopathy, myelopathy excluded by exam &

EMG/NCS

■Uremia & iron deficiency excluded by history & serum studies