Neonatal patent ductus arteriosus accompanied by acute heart failure and pulmonary edema: a case report and literature review / 中国中西医结合急救杂志

Objective To investigate the feasibility and safety of using vasodilators in the treatment of neonates with patent ductus arteriosus (PDA) accompanied by acute heart failure and pulmonary edema. Methods The clinical data of a case of neonatal PDA accompanied by severe cardiac insufficiency and pulmonary edema in Department of Intensive Care Unit (ICU) of Hebei General Hospital, and the neonate's hemodynamic characteristics and the efficacy and adverse reactions of phentolamine, a vasodilator, in the treatment of PDA were retrospectively analyzed. Results In this neonate, on the 8th day after birth and the improvement of pulmonary hyaline membrane disease, the respiratory distress occurred again, which was related to the severe cardiac dysfunction caused by the opening of PDA. Phentolamine was given on the basis of routine treatment to reduce systemic circulatory resistance. Two hours later, the respiratory distress was relieved significantly, that was presumably related to the decline of the left to right shunt volume through the PDA. There were no adverse reactions such as blood pressure reduction and coronary insufficiency. Conclusion Neonatal PDA is easily to be complicated with severe cardiac insufficiency, and vasodilators can reduce systemic circulatory resistance, reduce left to right shunt volume through the ductus arteriosus, and reverse the acute cardiac insufficiency and pulmonary edema, the therapeutic effect of vasodilators is remarkable, safe and reliable in neonatal PDA.

A case report of atypical atrial flutter in child / 天津医药

The characteristic of atypical atrial flutter episodes on electrocardiogram is different from the typical atrial flutter.Due to the poor diagnosis awareness about atypical atrial flutter,which is easily misdiagnosed as other arrhythmia,for example sinus arrhythmia,atrial fibrillation,and Ⅲ °atrioventricular block.Here we reported a case of atypical atrial flutter in child.In addition to the characteristics of typical atrial flutter,such as regular and more fixed atrial rhythm,fluctuated ventricular rate,faster atrial rate than the ventricular rate,the patient was found equipotential line,slow atrial rate,and uprighted F wave on the inferior wall leads and V 1 lead of electrocardiogram,which were different from typical atrial flutter.