Belhassen Ventricular Tachycardia in a Child.

First reported in 1981, idiopathic left ventricular tachycardia (VT) of the Belhassen type is characterized during electrocardiography (ECG) by a right bundle branch pattern and left axis deviation. We report the case of a 15-year-old Hispanic male who, during a routine evaluation ECG to support sports participation, was found to have nonsustained monomorphic VT. Prior to his exercise treadmill test, his physical examination and echocardiogram were normal. Then, during preparation for the exercise treadmill test, the ECG showed sustained monomorphic VT with a right bundle branch block pattern and superior QRS axis, suggesting a diagnosis of Belhassen VT.

Rare Case of Aortopulmonary Window With Anomalous Origin of Right Coronary Artery.

A 5-month-old infant presented with a rare, congenital heart disease: aortopulmonary window with an anomalous origin of the right coronary artery from the aortopulmonary window. Using echocardiography and computed tomography, the exact diagnosis could only be ascertained retrospectively; however, cardiac catheterization and angiography confirmed the diagnosis, which led to elective open-heart surgery. The infant made a full recovery.

Acute myocardial infarction in a teenager due to Adderall XR.

Adderall XR is commonly prescribed for children and adolescents with attention deficit/hyperactivity disorder. We present a case of a 15-year-old male who suffered a myocardial infarction after starting Adderall XR. Patient was otherwise in good health with no previous cardiac abnormalities. Cardiac catheterization was normal, and etiology was presumed to be secondary to acute vasospasm. The patient improved with cessation of medication. Physicians need to carefully screen patients for cardiac abnormalities prior to starting amphetamine-based medications.

Sweet syndrome, cutis laxa, and fatal cardiac manifestations in a 2-year-old girl.

A 2-year-old black girl was diagnosed with Sweet syndrome and cutis laxa, and she was given corticosteroid therapy. At that presentation, a cardiac evaluation revealed nothing unusual. Nine days later, she emergently presented with respiratory distress, and circulatory collapse rapidly developed. A 2-dimensional Doppler echocardiogram showed a dilated and poorly contractile left ventricle, severe aortic regurgitation, and a large aneurysm of the sinus of Valsalva. Despite resuscitative efforts, the child died. Inspection on autopsy revealed a markedly enlarged heart and 2 large aneurysms of the sinus of Valsalva. Histologic analysis disclosed acute necrosis in the cardiac apex and interventricular septum, and focal chronic inflammatory and granulation tissue in the aortic wall.Because cardiac lesions may remain clinically silent, we recommend that children with Sweet syndrome and cutis laxa undergo complete cardiac evaluation, including 2-dimensional Doppler echocardiography, by a pediatric cardiologist. Subsequent monitoring is also appropriate. Early recognition and aggressive therapeutic treatment could prevent fatal cardiac complications.

Kawasaki disease: giant aneurysm with a large thrombus of the left coronary artery.

We report a six-month-old febrile infant presenting with stridor. Later on, he developed typical Kawasaki disease with giant aneurysm of the coronary artery with thrombosis that resolved with an aggressive anticoagulation therapy. The giant aneurysm still persisted a year later. Respiratory illness with stridor is an unusual presentation of Kawasaki disease.

Giant aortic arch aneurysm after interrupted aortic arch repair.

An 8-year-old boy developed a large aneurysm of the aortic arch after neonatal complete repair of interrupted aortic arch type B and closure of a perimembranous ventricular septal defect. To our knowledge, this unusual complication has not been previously reported in the English literature.

Bjork surgery for tricuspid atresia--revisited.

We present a 19-year-old college student completely asymptomatic who underwent successful Bjork surgery (right atrium-to-right ventricle connection) in infancy with excellent results. Surgical approach for tricuspid atresia is done in three stages. Blalock Tuassig shunt soon after birth or pulmonary artery band depending on the size of the ventricular septal defect (VSD) and the main pulmonary artery, Glenn surgery (bidirectional cavopulmonary shunt) at 3-6 months of age, and Fontan surgery at 2-3 years age. There are many short- and long-term complications after Fontan surgery and patients require multiple medications throughout life. For tricuspid atresia with normally related great arteries, large VSD, and normal pulmonary valve, Bjork surgery offers the advantages of right ventricular growth, biventricular function, and good outcome without any medications.

Surgical issues in giant right ventricular fibroma.

Cardiac fibroma is a rare and benign tumor usually seen in infants and children. We report a 3-year-old asymptomatic child who presented with a giant right ventricular (RV) fibroma. He underwent complete surgical resection and is doing well at follow-up. Because of the size of the tumor and the potential need for resection of RV free wall, it is essential to have contingency plans to deal with postoperative RV failure.