Subject(s)
Humans , Pericardial Effusion/etiology , Pericarditis/complications , Cardiac Tamponade/etiology , Anti-Inflammatory Agents/therapeutic use , Clinical Evolution , Pericarditis/diagnosis , Pericarditis/drug therapy , Pericarditis/etiology , Pericardium/anatomy & histology , Pericardium/pathology , Punctures , Signs and SymptomsSubject(s)
Humans , Male , Infant, Newborn , Persistent Fetal Circulation Syndrome/diagnosis , Dobutamine/administration & dosage , Dopamine/administration & dosage , Echocardiography , Enalapril/administration & dosage , Furosemide/administration & dosage , Medigoxin/administration & dosage , Neurologic Manifestations , Parenteral Nutrition , Radiography, Thoracic/methods , Persistent Fetal Circulation Syndrome/physiopathology , Tolazoline/administration & dosageABSTRACT
A sporadic case of idiopathic asymmetric heart hypertrophy in a newborn infant is reported. Despite drug therapy the baby died in progressive heart failure at 23 days of age. At necropsy there was cardiac hypertrophy with features similar to those of the usual asymmetric from observed in adults. On gross examination the myocardium of the ventricular septum and the free wall of the left ventricle showed a disorganized structure. Microscopically, the changes consisted of an abnormal arrangement of muscle cells and muscle bundles with areas of hypertrophied myofibers. In agreement with other authors myocardial disorganization ("disarray") is interpreted as a form of dysplasia, hypertrophy being a secondary phenomenon. The hypothesis that these abnormalities represent the persistence of the embryonic myocardial structure is discussed. The pathogenetic significance of focal myocardial dysplasias is apparently related to the amount of myocardium involved.
Subject(s)
Cardiomyopathy, Hypertrophic/congenital , Heart Defects, Congenital/pathology , Cardiomyopathy, Hypertrophic/pathology , Ductus Arteriosus, Patent/pathology , Heart Septal Defects, Atrial/pathology , Humans , Infant, Newborn , Male , Myocardium/pathologyABSTRACT
Se realiza un estudio prospectivo para detectar elementos de Cor Pulmonale en niños con hiperplasia obstructiva de adenoides y/o amigdalas. Se evaluaron los exámenes disponibles para ello y los resultados después de adenoamigdalectomía. Se evaluaron clínicamente 24 niños (1 año 7 meses-5 años 2 meses) por ORL y Cardiólogo y se les efectuaron ECG, Rx tórax, gases arteriales, Ecocardiografía-Doppler. En 16 pacientes (67%) la Eco-D estuvo alterada (Hipertrofia y/o dilatación de Ventrículo derecho). Todos los ECG fueron normales. Se encontró hipoxemia en 5 niños. Los síntomas clínicos y los cambios Ecocardiográficos fueron revertidos después de la adenoamigdalectomía. La prevalencia de Hipertensión pulmonar en niños con hiperplasia adenoamigdalina aún es subestimada
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Adenoids , Airway Obstruction/complications , Pulmonary Heart Disease , Tonsillitis , Adenoidectomy/rehabilitationABSTRACT
La agenesia pulmonar es una anomalía extraordinariamente infrecuente, la cual se ha reportado aisladamente o en asociación con otras malformaciones congénitas. Se describe el caso de un recién nacido de término con agenesia pulmonar derecha ailada, diagnosticada en la primera semana de vida, a raíz de taquipnea asociada con presencia de meconio en el líquido amniótico, de corta evolución. Posteriormente, asintomática, tenía signos de desplazamiento del latido del corazón hacia el lado derecho, opacidad del campo pulmonar derecho, desviación del mediastino hacia el mismo y visualización de un solo diafragma -proyección lateral- en las radiografías de tórax y ausencia de arteria y venas pulmonares derechas en la angiografía pulmonar. No se obtuvo contraste del pulmón derecho en la cintigrafía pulmonar y en la angiografía isotópica. No se encontraron malformaciones cardíacas ni abdominales en sendas exploraciones ultrasonográficas. La paciente permaneció asintomática hasta las siete semanas de vida, pero falleció a los dos meses de edad a causa de neumonía severa
Subject(s)
Infant, Newborn , Humans , Female , Lung Diseases , Lung/abnormalities , Infant, Newborn, DiseasesABSTRACT
Conspicuous left axis deviation was found in two thirds (27 patients) of 44 children with a perimembranous ventricular septal defect, echocardiographic signs of apposition of the septal tricuspid valve leaflet, and an aneurysm of the membranous septum. In 10 patients earlier electrocardiograms did not show left axis deviation; this feature appeared when the aneurysm of the membranous septum was first seen on the echocardiogram. None of the 44 controls with perimembranous ventricular septal defect but without an aneurysm had left axis deviation. This study suggests that the appearances of conspicuous left axis deviation in a patient with ventricular septal defect indicate a spontaneous reduction in the defect by apposition of the septal tricuspid valve leaflet and by the formation of an aneurysm of the membranous septum.
Subject(s)
Electrocardiography , Heart Aneurysm/physiopathology , Heart Septal Defects, Ventricular/physiopathology , Adolescent , Child , Child, Preschool , Echocardiography , Heart Aneurysm/complications , Heart Septal Defects, Ventricular/complications , Heart Septal Defects, Ventricular/pathology , Humans , Infant , Random Allocation , Tricuspid Valve/pathologyABSTRACT
Five cases of neonatal infective endocarditis are reported. The mitral, tricuspid and pulmonary valves were involved either alone or in association. The predisposing factors were multiple: umbilical catheter, respiratory distress with assisted ventilation, septicemia, osteoarthritis or gastroenteritis. Only one child had a minor cardiac malformation. The causal organism was a staphylococcus aureus in all cases. All children had disseminated intravascular coagulation and a cardiac murmur. The diagnosis was confirmed by echocardiographic demonstration of bacterial vegetations. Three of the 5 children died despite long-term antibiotic therapy. In one case, a vegetation embolised to the pulmonary artery. In the two cured neonates the vegetations disappeared. These cases illustrate the value of echocardiography which should be performed in all neonates with septicemia or disseminated intravascular coagulation, especially when there is an associated cardiac murmur.
Subject(s)
Endocarditis, Bacterial/etiology , Staphylococcal Infections/complications , Disseminated Intravascular Coagulation/etiology , Echocardiography , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/therapy , Female , Heart Murmurs , Heart Valve Diseases/etiology , Humans , Infant, Newborn , Male , Mitral Valve , Pulmonary Valve , Tricuspid ValveABSTRACT
Se revisaron los antecedentes clínicos y de laboratório de 15 niños con enfermedad de Kawasaki, intentando identificar compromiso de las diferentes estructuras cardíacas, especialmente desde el punto de vista ecocardiográfico. La edad promedio fue 18,5 meses; 12/15 tuveron compromiso cardíaco (CC) consistente en 9 casos de lesiones coronarias y 3 de dilatación de cavidades. Las lesiones vasculares se localizaron en la arteria coronaria izquierda en 3, y en ambas coronarias en 6, con un total de 4 aneurismas. En 7,12 casos se normalizó el CCV, persistiendo alteraçöes coronarias en 5/12 aun a los 20 meses de seguimiento. Las alteraciones electrocardiográficas no fueron específicas de enfermedad isquémica; no hubo fallecimientos. Se observó derrame pericárdico en 5 casos y evidencias de miocarditis en un caso. Ningún paciente presentó disfunción valvular. Se concluye que el CC es un hecho frecuente en EK en nuestro, pero queda por determinar el pronóstico en el largo plazo de los niños afectados por esta enfermedad
Subject(s)
Infant , Child, Preschool , Humans , Male , Female , Coronary Disease/etiology , Mucocutaneous Lymph Node Syndrome/complications , Aspirin/therapeutic use , Coronary Disease/diagnosis , Echocardiography , Immunization, Passive , Mucocutaneous Lymph Node Syndrome/therapy , Prognosis , Retrospective StudiesABSTRACT
Cardiovascular complications (CVC) of Kawasaki disease (KD) are described in 15 affected children (10 boys, mean age 18.5 months). Clinical records, electrocardiographic tracings (ECG) and bidimensional echocardiograms (BDE) were analysed. In each case the first BDE was done at clinical diagnosis (mean time 10 days from initial symptoms of disease), then at weekly intervals for the first month and each two weeks along the second month. In children showing persistent coronary artery lesions (CAL) BDE was repeated monthly and in patients without CVC at three month intervals. During follow up, no definite clinical evidence of miocardial ischemia was found, but abnormal BDE recordings were obtained from 12/15 patient: CAL in 9/15; right ventricular, left ventricular and aortic enlargement in 3/15. CAL were located at the left coronary artery (LCA) in 3/9 (one LCA aneurysm) and at both coronary arteries in 6/9 (including 3 cases with bilateral aneurysms). All patients were given aspirin and seven were also treated with intravenous gammaglobulin, this last at day 9 (mean) of disease, but 5 of them developed CVC, including 3 cases of CAL.
