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Idorn L.,Section of Pediatric Cardiology
Minerva Pediatrica | Year: 2013

Primary cardiac arrhythmias are much less common in infants and children than adults and the symptoms presented may be vague and nonspecific. Though true emergencies due to unstable arrhythmias in children are rare it is critical to identify and appropriately manage these arrhythmias, since when left untreated, arrhythmias may lead to cardiopulmonary compromise and arrest. Most children with a primary arrhythmia present to a pediatrician, cardiologists, or emergency physicians before being referred to a pediatric cardiologist for assessment and management. Thus, the pediatricians, cardiologists, and emergency physicians have to be able to recognize the arrhythmia and in some cases to provide the acute treatment. This article is intended to provide diagnostic and management guidelines of the most common types of arrhythmias seen in children with structurally normal hearts.

Jensen A.S.,Rigshospitalet | Jensen A.S.,Imperial College London | Idorn L.,Section of Pediatric Cardiology | Norager B.,Rigshospitalet | And 2 more authors.
Heart | Year: 2015

Adults with congenital heart disease are a growing population. One of the major challenges in the care of these patients is to prevent thromboembolic episodes. Despite relative young age and no typical cardiovascular risk factors, this cohort has a high prevalence of thrombotic events. It is difficult to use treatment algorithms from the general adult population with acquired heart disease in this heterogeneous population due to special conditions such as myocardial scarring after previous surgery, atypical atrial flutter, prothrombotic conditions and the presence of interatrial shunts. Furthermore, there is a lack of scientific evidence regarding how to prevent thromboembolic events with anticoagulation in adults with congenital heart disease. The aim of this paper is to review the current literature pertaining to anticoagulation in adults with congenital heart disease and hence enable recommendations for which patients are likely to bene fit from which anticoagulation treatments, when they should be considered and how these would be carried out.

Gomez J.,Section of Pediatric Cardiology
The Journal of invasive cardiology | Year: 2012

An 8-year-old male patient was sent to the catheterization laboratory for assessment of a partial anomalous pulmonary venous connection found by echocardiography. During the intervention, cineangiogram revealed left pulmonary veins draining to the right atrium through left innominate and vertical veins. Despite this anatomical feature, these pulmonary veins were also connected to the left atrium. In a second intervention, we successfully occluded the vertical vein using a vascular closure device (Amplatzer Vascular Plug II, AGA Medical), redirecting pulmonary venous flow towards the left atrium. Anatomy, technique, and management of the procedure are discussed here.

Cabrera M.,Adult Congenital Heart Disease Program | Contreras A.,Private Hospital of Cordoba | Peirone A.,Section of Pediatric Cardiology
Journal of Invasive Cardiology | Year: 2011

Percutaneous atrial septal defect closure has been demonstrated to be a safe and effective procedure. Many different devices have been utilized during the last decade with a low complication rate. We report a patient who presented with cardiac tamponade 6 months after ASD closure using the Solysafe device. Emergency surgery demonstrated a disarticulated device as well as a broken wire migrated into the pericardial space causing cardiac perforation and tamponade. To the best of our knowledge, this is the first report of late cardiac perforation following ASD closure using the Solysafe device.

Caughey R.W.,Tulane University | Humphrey J.M.,Tulane University | Humphrey J.M.,Tulane University Medical Center | Thomas P.E.,Section of Pediatric Cardiology
Ochsner Journal | Year: 2014

Background: Viral myocarditis is a common cause of transient electrocardiogram (EKG) abnormalities in children. The clinical presentation of acute myocarditis ranges from asymptomatic infection to fulminant heart failure and sudden death. Many children present with nonspecific symptoms such as dyspnea or vomiting, frequently leading to misdiagnosis. EKG abnormalities are a sensitive indicator of acute myocarditis and are present in more than 90% of cases. Case Report: A 13-year-old female suffered a syncopal episode and was found to have high-grade atrioventricular (AV) block caused by acute presumed viral myocarditis. With close monitoring, the EKG abnormalities resolved over the following 48 hours. In this case report, we discuss the incidence, pathogenesis, and outcomes of conduction disturbances in acute myocarditis. Conclusion: High-degree AV block can occur in patients with acute myocarditis, and higher-degree AV block is correlated with greater myocardial injury. Additionally, severity of pathological changes may reflect the reversibility of AV block. In the majority of cases, however, this rhythm disturbance is transient and does not require permanent pacemaker placement. © Academic Division of Ochsner Clinic Foundation.

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