Heart failure in children: clinical aspect and management.

Heart failure (HF) is a complex syndrome, with several definitions, the commonest being "an abnormality of cardiac function whereby heart in unable to pump at a rate commensurate with the requirement of the metabolizing tissues, or does so only at elevated filling pressures". In case of children, this requirement includes growth and development. Unlike as seen in adults, HF in children is commonly due to structural heart disease and reversible conditions. Thus the treatment for HF is commonly required for short term only. The overall outcome with HF is better in children than in adults. While the general principles on management are similar to those in adults, the evidence for the use of drugs in children is less convincing. It requires a judicious balance of extrapolation from adult medicine, keeping in mind that children are not small adults.

La hipoplasia del ventrículo derecho en la anomalía de Ebstein / Hypoplasia of the right ventricle in the Ebstein anomaly

Se informa el caso de un niño de seis años con cardiopatía congénita cianótica e insuficiencia cardiaca congestiva; al efectuar la autopsia, el corazón mostró características morfológicas de la anomalía de Ebstein con hipoplasia de la porción trabecular del ventrículo derecho. El desplazamiento distal del orificio tricuspídeo, con fusión de las valvas septal y posterior de la pared ventricular fue el criterio morfológico más útil para diferenciarla de otras cardiopatías que cursan con hipoplasia miocárdica del ventrículo derecho como la anomalía de Uhl, y la displasia del ventrículo derecho, entre otras cardiopatías secundarias. Se analiza el diagnóstico diferencial entre las anomalías que presentan ausencia parcial o difusa del miocardio del ventrículo derecho.

Hepatic hemangioendothelioma of infancy with congestive cardiac failure--report of a case.

A case of infantile hemangioendothelioma of the liver is reported in a 18 day-old male neonate. The neonate presented with CHF. He had hepatomegaly, but lacked the third component of the classical triad i.e. cutaneous hemangiomas. The S.A.F.P levels were raised to 920 ng/ml, though rise is rare in infantile hemangioendothelioma and led to the clinical diagnosis of hepatoblastoma. A left hepatic resection was performed, the histology showed a type I pattern of the tumor. This is known to be associated with a good prognosis. The baby is well post resection for a follow up period of six months.