An equivalent posture to squatting is seen in an unoperated adult with tetralogy of Fallot

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Enhancing FD-EMI in-phase observations by means of 3D inversion: the case of Orcines, France

FD-EMI in-phase data were collected at a Gallo-roman site in Orcines, France. 3D inversion unveils features, which are not visible in the recorded in-phase maps

Atipical kawasaki disease with coronary aneurysm in infant

Kawasaki disease is an acute febrile disease of unknown etiology, characterized by systemic vascular inflammation involving the small and medium sized arteries, with a predilection for the coronary arteries. It represents the leading cause of acquired heart diseases in children in developed countries. Diagnosis, difficult because of the clinical characteristics of the disease with typical signs and symptoms appearing sequentially and not simultaneously, may be even more complicated in case of unusual presentation, leading to delay in recognition, particularly in infant in whom a higher incidence of coronary arteries aneurysms has been reported. A high index of suspicion of Kawasaki disease must be maintained in case of prolonged fever in these patients. Timely appropriate treatment is essential to avoid severe sequels. We report the case of a 2 months old male infant with persistent febrile episode, transferred to us from another institution, who presented on echocardiography giant aneurysms on both coronary arteries

Congenital and acquired coronary arteries anomalies in enfant, children and adolescents: combination of echocardiography and cardiac magnetic resonance imaging

Conventional angiography and Computer tomography are currently the modalities of choice to assess and delineate coronary arteries anatomy. However both techniques carry risks associated with the exposure to ionizing radiation and iodinated contrast agents, morever conventional angiography presents the disadvantage of its invasive nature, the lacks of three-dimensional information and the ability to image soft tissue, making it difficult to demonstrate the spatial relationship among the coronary artery course, myocardium, and great vessels. Although angiography by CT scan and cardiac catheterization are still the gold standard for the imaging of the coronary arteries, continuous progress and improvement and the extraordinary sophistication of non – invasive imaging technique such as echocardiography and magnetic resonance imaging (MRI), in combination, cannow provide a complete non-invasive alternative evaluation of the anatomic origins and courses of the coronary arteries with exquisite accuracy. Use of these techniques, therefore, will increase the ability to diagnose an increased number of abnormal arrangements. MRI can provide high resolution, high contrast, anatomical images in freely-selectable 2D planes or true 3D volume scans. Anatomical images, combined with the functional information provided by cine, velocity mapping, and dynamic contrast angiography techniques make MRI ideally suited to the evaluation of the coronary anomalies

Prophylaxis protects infants with congenital heart disease from severe forms of RSV infection: an Italian observational retrospective study

Abstract Background In children with congenital heart disease (CHD) respiratory syncytial virus (RSV) infection may have a severe course, with increased risk of morbidity and mortality, requiring hospital admission and intensive care. The aim of the present study was to evaluate the effect of prophylaxis with palivizumab in preventing RSV-associated hospitalization in infants with CHD. Methods We carried out an observational, retrospective study in a paediatric cardiology division at a secondary-care centre in Italy, extracting from the database children with CHD who, from November 2004 to March 2022, matched the criteria for palivizumab prophylaxis, to evaluate the hospitalization rate in CHD patients with and without palivizumab prophylaxis and their RSV-related hospitalization characteristics compared with a group of children without CHD and no other underlying clinical conditions (control group, CG), hospitalized for RSV infection. Results One hundred twenty-eight children with CHD were enrolled in the study, mainly (71.9%) with increased pulmonary flow, and received palivizumab prophylaxis. Twenty-seven received hospital care for bronchiolitis. Almost all CHD patients hospitalized for bronchiolitis (26 out of 27) received partial prophylaxis (≤ 3 doses). CHD patients with bronchiolitis stay longer in the hospital than control (14.4 ± 21.7 days vs 6.2 ± 2.3 days) some of which require intensive care (n = 4). Conclusions Our study provides evidence of the efficacy of palivizumab in protecting patients with hemodynamically significant CHD under the age of 2 years from RSV disease and its life-threatening complications. Reducing hospitalisation rate, morbidity, and mortality in this category of patients, passive immune prophylaxis with palivizumab may impact healthcare resource availability and utilisation

Glycopyrrolate and theophylline for the treatment of severe pallid breath-holding spells

Severe pallid breath-holding spells (BHSs) are based on parasympathetic hyperactivity, leading to cardiac asystole, pallor, brain ischemia, loss of consciousness, and reflex anoxic seizures. In recent years, an increasing number of patients with severe pallid BHSs have been successfully treated with pacemaker implantation. We present the case of a 13-month-old girl suffering from repeated severe pallid BHSs, causing asystole, loss of consciousness, and generalized anoxic seizures. She underwent treatment with oral glycopyrrolate, an anticholinergic drug, and an oral retard preparation of theophylline. The aim of the treatment was to decrease cardiac inhibition with glycopyrrolate and to bring about a positive chronotropic effect with theophylline. In our case, the combined therapy was effective in suppressing syncope and reflex anoxic seizures associated with BHSs This avoided the need for ventricular pacemaker implantation