Congenital left ventricular diverticulum associated with ASD, VSD, and epigastric hernia

Congenital left ventricular diverticulum is a rare cardiac malformation. Two categories of congenital ventricular diverticulum have been identified with regard to their localization: apical and non-apical. Apical diverticula are always associated with midline thoraco-abdominal defects and other heart malformations. Non-apical diverticula are always isolated defects. Diagnosis is established by imaging studies such as echocardiography, magnetic resonance imaging, or left ventricular angiography. Mode of treatment has to be individually tailored and depends on clinical presentation, accompanying abnormalities, and possible complications. We report a 10-month-old girl with left ventricular apical diverticulum, large atrial septal defect, two small muscular ventricular septal defects, and pulmonary hypertension, associated with epigastric hernia. This patient underwent total surgical repair for intra-cardiac defects as well as diverticular resection

Efficacy of adenosine for acute treatment of supraventricular tachycardia in infants and children

This study was done to assess the efficacy and adverse effects of the different doses of adenosine in the pediatric age group with respect to multiple patient variables. Over a period of 1 year, 86 occasions of supraventricular tachycardia [SVT] were treated with adenosine in 81 infants and children aged between 18 days and 12 years [median of 1.3 years, SD=3]. Adenosine efficacy was evaluated in terms of the patients' demographics, SVT rate, electrocardiogram characteristics, and route of drug administration. The dose of 50microg/kg was effective only in 24% of the SVT cases, and the additional doses of 100microg/kg, 150microg/kg, and 200microg/kg were effective in another 29% of the cases. The drug efficacy was higher in the infants than that in the older children. There were no predictors other than age for the estimation of the efficacy of the drug. Our findings showed that the current recommended doses of adenosine are ineffective in the vast majority of children and infants with SVT. No patient-related factor other than age seems to affect the efficacy of the drug