ABSTRACT
BACKGROUND: Rhabdomyoma is the most frequent primary cardiac tumour in children (about 50% of all cardiac neoplasms in this population). Fibroma, myxoma, teratoma and haemangioma are less frequent. AIM: To investigate the clinical presentation, diagnosis and follow-up of children diagnosed with cardiac tumours in our department between 1993 and 2008. METHODS: In the 15-year review we found 9 cases of cardiac tumours, confirmed in echo scan in every case and pathomorphologically in 5 out of 9 cases. RESULTS: Cardiac tumours were found in six boys and three girls, usually in the neonatal period. Cardiac murmur was the most common clinical symptom (4 cases). Two children were symptom-free. Out of the remaining children, two had circulatory failure and one had arrhythmia. Five children were operated on: three cases of rhabdomyoma, one fibroma and one teratoma. In 3 children who did not undergo surgery, the most probable diagnosis was rhabdomyoma. The follow-up (possible in 8 out of 9 cases, mean 7 years) showed that six children developed regularly and in two cases neurological abnormalities appeared. CONCLUSIONS: In this series, primary cardiac tumours presented as murmurs or circulatory failure. Most children needed surgery. In most cases, pathomorphology revealed rhabdomyoma. Follow-up showed regular development in six out of nine cases.
Subject(s)
Fibroma/diagnosis , Heart Neoplasms/diagnosis , Rhabdomyoma/diagnosis , Teratoma/diagnosis , Disease Progression , Female , Fibroma/pathology , Fibroma/surgery , Follow-Up Studies , Heart Neoplasms/pathology , Heart Neoplasms/surgery , Humans , Infant , Male , Rhabdomyoma/pathology , Rhabdomyoma/surgery , Teratoma/pathology , Teratoma/surgeryABSTRACT
The authors described the case of 5-year-old boy, in whom a proper diagnosis was established after 19 months. In differential diagnosis, epileptic, tetanic and conversion seizures were taken into consideration.
Subject(s)
Epilepsy/diagnosis , Long QT Syndrome/diagnosis , Child, Preschool , Diagnosis, Differential , Electrocardiography , Heart Conduction System , Humans , Male , Time FactorsABSTRACT
Authors describe the case of 4 years old girl with Down syndrome, who was operated due to common atrio-ventricular canal and persistent Botalli's duct. Intermittent total atrio-ventricular block (without significant bradycardia) has been observed one year later and considered as a late postoperative block requiring no treatment. Kawasaki disease was diagnosed because of the presence of 4 out of 6 leading symptoms appearing in typical chronology (fever, mouth and throat inflammation, conjunctivitis, erythema with subsequent desquamation of skin on palms and feet). ECG revealed total atrio-ventricular block, however with significant bradycardia. ECHO showed aneurysms in both coronary arteries. Standard treatment of Kawasaki disease was administered (immunoglobulins, acetylsalicylic acid) and orciprenalin due to described cardiac block. Pacemaker was implanted because of bradycardia. The literature review showed that the treatment with immunoglobulins and aspirin can reduce the risk of coronary aneurysms development. On the other hand, identification of patients at risk coronary aneurysms development is not possible on the ground of biochemical blood analysis and physical signs. Thus, all the patients stricken should be treated with described above costly drugs (immunoglobulins). Finally, the algorithm of procedures in patients with coronary aneurysms was presented.
Subject(s)
Mucocutaneous Lymph Node Syndrome/diagnosis , Mucocutaneous Lymph Node Syndrome/therapy , Pacemaker, Artificial , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Aspirin/therapeutic use , Bradycardia/etiology , Child , Coronary Aneurysm/etiology , Coronary Vessels/diagnostic imaging , Diagnosis, Differential , Down Syndrome , Echocardiography, Transesophageal , Female , Fever of Unknown Origin/etiology , Humans , Immunoglobulins, Intravenous/therapeutic use , Mucocutaneous Lymph Node Syndrome/complications , Mucocutaneous Lymph Node Syndrome/drug therapyABSTRACT
8 patients suffering transposition of the great arteries (d-TGA) aged from 8-17 years (mean 12.6 years) after Senning procedure performed were analyzed. Right atrium and right ventricle enlargement was detected in all patients. Small jet tricuspid valve regurgitation was confirmed in 5 patients, significant tricuspid valve insufficiency in 3 patients. 4 patients had presented with tricuspid valve, aorta valve and mitral valve insufficiency. In one patient insignificant pulmonary artery stenosis had been diagnosed. Chronic cardiac failure (NYHA III/IV) has been diagnosed in 2 patients, other patients from the analyzed group are in good clinical condition. All patients but 2 were diagnosed with arrhythmia using 24-hour Holter ECG. In 2 patients sinus node dysfunction was noted. Also supraventricular extrasystole, ventricular extrasystole, supraventricular tachycardia, ventricular salve, paroxysmal atrial fibrillation were described. No drug therapy in 4 patients is needed, one is treated with ACE-inhibitors, one with diuretic drugs. 2 patients suffering cardiac failure had been treated with 4 drugs, also temporary with intravenous dopamine. One death had been noted, caused by serious arrhythmia. One patient had been qualified for heart transplantation, there is no further data regarding this case. Senning procedure can be considered high risk for various problems, so patients who underwent this type of correction should be carefully observed.
