• Title/Summary/Keyword: Pediatric cardiology

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A case of constrictive pericarditis presenting with protein-losing enteropathy (단백 소실성 장병증을 동반한 교착성 심낭염 1례)

  • Hong, Jeong Mi;Lee, Jae Young;Kim, Soo Jin;Jang, Gi Young;Shim, Woo Sup
    • Clinical and Experimental Pediatrics
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    • v.49 no.8
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    • pp.898-901
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    • 2006
  • Constrictive pericarditis represents a rare cause of protein-losing enteropathy in children. Reported is an 11-year-old girl with protein-losing enteropathy (PLE) as the principal manifestations of constrictive pericarditis. After total pericardiectomy, symptoms and signs of PLE disappeared. Doppler echocardiography including tissue Doppler imaging is a useful noninvasive initial diagnostic tool for differential diagnosis of diastolic heart failure.

Circardian rhythm of cardiac nonlinear dynamics in healthy human

  • Yum, M.K.;Kim, N.S.;Oh, J.W.;Kim, C.R.;Lee, J.H.;Kim, S.K.;Lee, J.M.
    • Proceedings of the KOSOMBE Conference
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    • v.1997 no.11
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    • pp.323-326
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    • 1997
  • In this study, we investigated the circardian rhythm of complexity of cardiac dynamics in humans. Dynamic 24-hour electrocardiographic recordings were obtained from 30 healthy ambulant subjects aged 41 to 50 years. or each recordings, normalized low frequency (0.04-0.1 hertz) and high frequency (>0.15 hertz) component are calculated. our different indexes obtained from separate algorithms of nonlinear dynamics - approximate entropy, correlation dimension, Lyapunov exponent and fractal dimension - were calculated. During early morning, low frequency component rose rapidly with concomitant withdrawl of high frequency component. All the our indexes of nonlinear dynamics showed remarkably same circardian rhythm: an early morning dip preceded by a steep decline during late night, a gradual recovery during evening and a peak around midnight. These data indicate that the simultansous losses of all of the our different mechanisms of nonlinear control of heart rate during early morning, concomitent with the surge of symapathetic activity and reduction of vagal activity, may contribute to the increased incidence of cardiovascular events during morning hours.

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Clinical outcome of transcatheter closure of patent ductus arteriosus in small children weighing 10 kg or less

  • Park, Young-A;Kim, Nam-Kyun;Park, Su-Jin;Yun, Bong-Sic;Choi, Jae-Young;Sul, Jun-Hee
    • Clinical and Experimental Pediatrics
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    • v.53 no.12
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    • pp.1012-1017
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    • 2010
  • Purpose: Transcatheter closure has become an effective therapy in most patients with patent ductus arteriosus (PDA). However, there are difficulties in transcatheter closure of PDA in small children. We reviewed clinical outcomes of transcatheter closure of PDA in children weighing less than 10 kg in a single center. Methods: Between January 2003 and December 2009, 314 patients with PDA underwent transcatheter closure in our institute. Among them, 115 weighed less than 10 kg. All of these patients underwent transcatheter closure of PDA using either COOK Detachable $Coil^{(R)}$, PFM Nit-$Occlud^{(R)}$, or Amplatzer duct $occluder^{(R)}$. A retrospective review of the treatment results and complications was performed. Results: The mean age of patients was $9.1{\pm}5.9$ months (median, 8 months), and mean weight was $7.6{\pm}1.8kg$ (median, 7.8 kg). The mean diameter of PDA was $3.2{\pm}1.4mm$ (median, 3 mm). Complete occlusion occurred in 113 patients (98%). One patient was sent to surgery because of a failed attempt at device closure, and another patient had a small residual shunt after device placement. The average mean length of hospital stay was $3.0{\pm}3.3$ days, and mean follow-up duration was $21.0{\pm}19.6$ months. There were no major complications in any of the patients. Conclusion: Transcatheter closure of PDA is considered safe and efficacious in infants weighing less than 10 kg. With sufficient experience and further effort, transcatheter closure of PDA can be accepted as the gold standard of treatment for this group of patients.

Pulmonary hypertension due to obstructive sleep apnea in a child with Rubinstein-Taybi syndrome

  • Choi, Hyung Soon;Yu, Jeong Jin;Kim, Young-Hwue;Ko, Jae-Kon;Park, In-Sook
    • Clinical and Experimental Pediatrics
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    • v.55 no.6
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    • pp.212-214
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    • 2012
  • Rubinstein-Taybi syndrome (RTS) is characterized by peculiar facies, mental retardation, broad thumbs, and great toes. Approximately one-third of the affected individuals have a variety of congenital heart diseases. They can also have upper airway obstruction during sleep, due to hypotonia and the anatomy of the oropharynx and airway, which make these patients susceptible to obstructive sleep apnea (OSA). In our case, pulmonary hypertension was caused, successively, by congenital heart defects (a large patent ductus arteriosus and arch hypoplasia) and obstructive sleep apnea during early infancy. The congenital heart defects were surgically corrected, but persistent pulmonary hypertension was identified 2 months after the operation. This pulmonary hypertension was due to OSA, and it was relieved by nasal continuous positive airway pressure. This case is the first report of pulmonary hypertension from OSA in a young infant with RTS.

Traumatic ventricular septal defect in a 4-year-old boy after blunt chest injury

  • Kim, Yun-Mi;Yoo, Byung-Won;Choi, Jae-Young;Sul, Jun-Hee;Park, Young-Hwan
    • Clinical and Experimental Pediatrics
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    • v.54 no.2
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    • pp.86-89
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    • 2011
  • Traumatic ventricular septal defect (VSD) resulting from blunt chest injury is a very rare event. The mechanisms of traumatic VSD have been of little concern to dateuntil now, but two dominant theories have been described. In one, the rupture occurs due to acute compression of the heart; in the other, it is due to myocardial infarction of the septum. The clinical symptoms and timing of presentation are variable, so appropriate diagnosis can be difficult or delayed. Closure of traumatic VSD has been based on a combination of heart failure symptoms, hemodynamics, and defect size. Here, we present a case of a 4-year-old boy who presented with a traumatic VSD following a car accident. He showed normal cardiac structure at the time of injury, but after 8 days, his repeated echocardiography revealed a VSD. He was successfully treated by surgical closure of the VSD, and has been doing well up to the present. This report suggests that the clinician should pay great close attention to the patients injured by blunt chest trauma, keeping in mind the possibility of cardiac injury.

Log-transformed plasma level of brain natriuretic peptide during the acute phase of Kawasaki disease is quantitatively associated with myocardial dysfunction

  • Bang, Sun-Hee;Yu, Jeong-Jin;Han, Myung-Ki;Ko, Hong-Ki;Chun, Sa-Il;Choi, Hyung-Soon;Kim, Young-Hwue;Ko, Jae-Kon;Park, In-Sook
    • Clinical and Experimental Pediatrics
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    • v.54 no.8
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    • pp.340-344
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    • 2011
  • Purpose: Brain natriuretic peptide (BNP) has been considered a biochemical marker for myocarditis in Kawasaki disease. We performed this study to determine its quantitative significance. Methods: We attempted to correlate log-transformed BNP concentrations (log-BNP) and clinical, laboratory, and echocardiographic variables in 81 children with Kawasaki disease. Stepwise multiple linear regression analysis was used to determine the variables independently associated with log-BNP concentration. Results: Serum C-reactive protein level (P<0.0001), serum alanine aminotransferase concentration (P =0.0032), white blood cell count (P=0.0030), and left ventricular mass index (P=0.0024) were positively related with log-BNP, and hemoglobin level (P<0.0001), serum albumin level (P<0.0001), $Na^+$ concentrations (P<0.0001), left ventricular fractional shortening (P=0.0080), and peak early diastolic tissue velocity of the left ventricular basal lateral segment (P=0.0045) were negatively related to the log-BNP concentration. Multiple regression analysis showed that serum albumin concentration ($R_2$=0.31, P=0.0098) and left ventricular mass index ($R_2$=0.09, P=0.0004) were significantly associated with the log-BNP concentration. Conclusion: Elevated BNP levels during the acute phase of Kawasaki disease may be attributable to cardiac dysfunction associated with the increase in left ventricular mass, and log-BNP concentration may be a quantitative biochemical marker of myocarditis in Kawasaki disease.

Cardiac Resynchronization Therapy in Infant with Dilated Cardiomyopathy during Extracorporeal Membrane Oxygenator

  • Bang, Ji Hyun;Oh, You Na;Ko, Jae-Kon;Kang, So Yeon;Baek, Jae Suk;Park, Chun Soo
    • Journal of Chest Surgery
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    • v.48 no.1
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    • pp.55-58
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    • 2015
  • Although heart transplantation is a final therapeutic option in pediatric patients with dilated cardiomyopathy (DCMP), the shortage of pediatric heart donors is a major obstacle. In adults with DCMP characterized by cardiac dyssynchrony, cardiac resynchronization therapy (CRT) is known to be an effective treatment option. However, there is a lack of evidence on the effectiveness of CRT in infants with DCMP. Several studies have reported improvement in hemodynamics and cardiac performance following CRT in infants with DCMP. Here, we report CRT in an infant with DCMP during extracorporeal membrane oxygenation with 5 months of follow-up.