Malignant Arrhythmia with Benign Tumour: Fibrolipoma of the Left Ventricle

We report a case of young male referred for evaluation of recent onset recurrent syncope. Inhospital electrocardiogram revealed an episode of ventricular flutter which reverted spontaneously to sinus rhythm. Transthoracic echocardiogram showed hyperechoic mass in the left ventricle. For further tissue characterization a cardiac magnetic resonance imaging was done which revealed a left ventricular mass with predominant fat content. The tumor was surgically resected. Histopathological examination confirmed the diagnosis of cardiac fibrolipoma. The patient recovered and is currently asymptomatic.

Oscilação oral de frequência reduz a obstrução das vias aéreas em crianças com pneumonias? / Flutter can improve lung obstruction in children with pneumonia?

Introdução: A pneumonia pode determinar quadro respiratório obstrutivo e acúmulo de secreção, e técnicas de higiene brônquica favorecem a sua eliminação. As mudanças dela decorrentes podem ser avaliadas pela medição do Pico de Fluxo Expiratório (PFE). Objetivos: Analisar as variações do PFE em crianças com diagnóstico de pneumonia (clínico e radiológico) antes e após a realização das técnicas de oscilação oral de alta frequência (OOAF) e técnica de expiração forçada (TEF). Pacientes e Métodos: Foi realizado estudo randômico controlado com crianças hospitalizadas por diagnóstico clínico e radiológico de pneumonia, e idades entre seis e doze anos. Foram constituídos dois grupos: Controle (C, tosse) e outro submetido a OOAF+ TEF. Frequência cardíaca (FC), frequência respiratória (FR), PFE, a ausculta pulmonar (AP) foram avaliados antes e após a intervenção. Resultados: 17 crianças do grupo OOAF+ TEF e nove do C foram avaliadas (média de idade = nove anos). Houve aumento do PFE (% previsto) apenas no grupo tratamento (65,8%± 14,3% pré vs S0,7%±15,6% após intervenção, p=0,00l). Entre os C o aumento não foi significante (66,3%±12,3% pré vs 77,9%±14,5% após intervenção, p=0,146). Não houve alteração da FC e FR em ambos os grupos. Observou-se melhora qualitativa na ausculta pulmonar no grupo OOAF+ TEF após a intervenção. Conclusões: As técnicas OOAF e TEF associadas foram eficazes para a desobstrução das vias aéreas, aumentando o PFE e melhorando qualitativamente a AP em crianças hospitalizadas com diagnóstico de pneumonia.

Introduction: Pneumonia can cause airway obstruction and increase lung secretion. Chest physiotherapy aids pulmonary expectoration that can cause changes in the airway patency and can be measured by Peak Expiratory Flow rate (PEF). Objectives: To evaluate the PEF variation in children with pneumonia diagnosis (clinicai and radiologic) pre and post Flutter technique and forced expiratory technique (FET) associated was applied. Patients and Methods: Open and randomized study of 26 hospitalized children due to pneumonia, aged from 6 to 12 years was conducted. The children were divided into two groups according to the treatment they received: Flutter + FET (F+FFT) and Control (C, cough). Heart rate (HR), respiratory rate (RR), EPF and pulmonary auscultation were recorded before (pre) and post intervention. Results: 17 children were treated with F+FET and 9 with C (mean age was 9 years old). An increase in the EPF was observed only in the F+FET group (% of prediction) (65.8%±14.3% pre vs 50.7%±15.6% post intervention, p=0.00l). No changes were observed in the C group (66,3%±12,3% pre vs 77.9%± 14.5% post intervention, p=0.146). No significant changes regarding RR and HR were observed in both groups. However, there was a qualitative improvement in PA in the F+FET group. Conclusions: The associated treatment with Flutter and FET proved to be efficient improving PEF and PA in hospitalized children with pneumonia diagnosis.