Assuntos
Miocardite/diagnóstico , Febre Reumática/diagnóstico , Antibacterianos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Aspirina/uso terapêutico , Cardiotônicos/uso terapêutico , Pré-Escolar , Digoxina/uso terapêutico , Feminino , Febre/etiologia , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/etiologia , Humanos , Miocardite/tratamento farmacológico , Miocardite/etiologia , Febre Reumática/complicações , Febre Reumática/tratamento farmacológicoRESUMO
A 12-year-old boy presented acutely after an episode of syncope with perioral cyanosis. He died 19 hours after admission due to cor pulmonale as a complication of metastatic desmoplastic small round cell tumor in the lungs with associated tumor thrombotic microangiopathy.
Assuntos
Tumor Desmoplásico de Pequenas Células Redondas/complicações , Neoplasias Pulmonares/complicações , Doença Cardiopulmonar/etiologia , Microangiopatias Trombóticas/etiologia , Criança , Evolução Fatal , Humanos , MasculinoRESUMO
During a recent volunteer medical mission to the Dominican Republic, we administered anesthesia to a child with severe pulmonary valvular stenosis and suprasystemic right ventricular pressure. This patient underwent a balloon pulmonary valvuloplasty but then developed worsening right ventricular outflow tract obstruction that required immediate therapy to prevent a low cardiac output state. As the development of hyperdynamic right ventricular outflow tract obstruction cannot be predicted, we emphasize the need for preemptive hydration and beta-blockade therapy prior to balloon dilatation.
