ABSTRACT
Primary intracardiac tumors are an infrequent occurrence during infancy and childhood and the most common amongst the primary cardiac neoplasms are myxomas, which have an estimated incidence of approximately 2-3 per 100,000 population. The atrial myxoma has a preponderance to occur in the left atrium with only a 25% incidence in the right atrium. Depending upon the site and the size of the neoplasm, the clinical picture varies and may range from no significant symptoms to cardiac arrest. Hence, the diagnosis and management of this condition requires highly specialized multidisciplinary input by the perioperative caregivers including cardiologists, cardiothoracic surgeons, anesthesiologists and the nurses specialized to deal with this unique population. There is a dearth of available literature on the anesthetic management of these primary intra-cardiac tumors with reports of neonatal right atrial myxoma excision a true rarity. We report the successful anesthetic management of one such case of a right atrial mass in an 18 days old female child
ABSTRACT
Posterior Reversible Encephalopathy Syndrome [PRES] is clinically characterized by seizures, lethargy, nausea and visual impairment. These findings are thought to be due to vasogenic edema, predominantly in the posterior cerebral hemispheres and are reversible with appropriate management. Neurogenic-stunned myocardium is a syndrome of reversible left ventricular dysfunction, associated with excessive sympathetic discharge states like pheochromocytoma, high-grade subarachnoid hemorrhage [SAH], status epilepticus and significant emotional stress. Here, we report a case of PRES and Neurogenic-stunned myocardium occurring simultaneously in a 25 year old primigravida at 34 weeks of gestation with twin pregnancy who presented to the emergency department with eclampsia and fetal distress. A careful review of literature did not return any report where these two conditions co-existed in an obstetric patient