PROGRESS IN PEDIATRIC CARDIOLOGY最新文献

英文中文

Developmental screening and assessment in congenital heart disease

IF 0.6 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2024-11-24 DOI: 10.1016/j.ppedcard.2024.101772

Kahlea Haladwala, Edwin Boyer, Ginger Llivina, Stephanie Anderson, Induja Gajendran, Sara Shank

Background

Congenital heart disease is a wide category of structural and functional heart abnormalities present at birth, including defects in the cardiac muscle, septa, valves, arteries, or veins. Patients with congenital heart disease are at an increased risk of developing adverse neurodevelopmental outcomes.

Aim of review

The purpose of this article is to review developmental screening and evaluation along with neurodevelopmental outcomes associated with congenital heart disease, including risk factors and genetic syndromes.

Key scientific concepts of review

Congenital heart disease is associated with adverse neurodevelopmental outcomes in various domains, including motor, language, cognitive, and academic abilities. Risk factors for neurodevelopmental delay may include abnormal fetal oxygen delivery, prematurity, low birth weight, cyanosis, surgical intervention, and genetic factors. Genetic syndromes associated with congenital heart disease and neurodevelopmental disabilities include Down (trisomy 21), Turner, 22q11.2 deletion, Williams, CHARGE, Noonan, Alagille, and Kabuki syndromes. Developmental screening with a standardized tool may identify the risk of abnormal development. All children receive general developmental screening at the 9-, 18-, and 30-month visits and autism-specific screening at 18- and 24-month visits. General developmental screening tests address multiple developmental domains, whereas other screening tests may focus on specific conditions such as autism or developmental domains, including speech and language. Developmental evaluation with standardized testing and rating scales by a qualified professional is recommended for children with congenital heart disease who are at high risk of neurodevelopmental sequelae. Clinical practice in cardiac developmental centers is highly varied, with most resources used for evaluation of children between birth and age 5 years. The need for early therapeutic intervention for high-risk pediatric patients with congenital heart disease supports early referral for evaluation and treatment. In high-risk school-aged patients, developmental evaluation may improve access to academic services, an individualized education plan, small group academic instruction, and instructional supports.

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引用次数: 0

Supraventricular tachycardia in children

IF 0.6 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2024-11-22 DOI: 10.1016/j.ppedcard.2024.101771

Zoha Nizami , Phoebe Garcia , Paras Ahuja , Aaron James Nipper , Sachi Patel , Hridhay Sheth , Induja Gajendran , Reshvinder Dhillon

Background

Supraventricular tachycardia (SVT) affects 1 in 500 children and is characterized by rapid heart rate originating from the atrial tissue above the atrioventricular node and interventricular septum.

Aim of review

The purpose of this article is to review the etiology, pathophysiology, types, clinical presentation, diagnosis, and treatment of SVT in children.

Key scientific concepts of review

SVT results from reentry circuits, abnormal automaticity, or triggered activity. Contributing factors include congenital heart defects, electrolyte imbalances, and genetic predisposition. The types of SVT include atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia, atrial tachycardia, and junctional ectopic tachycardia. Infants with SVT may present with poor feeding, vomiting, irritability, increased sleepiness, syncope, or diaphoresis. Toddlers and school-aged children may experience palpitations, chest pain, dizziness, shortness of breath, or syncope. Diagnostic tests include the electrocardiogram, Holter monitor, exercise stress test, and electrophysiologic study. Acute treatment options include vagal maneuvers, pharmacologic cardioversion, and electrical cardioversion. Long-term treatment options include antiarrhythmic drugs, catheter ablation, and surgical treatment. Complications of SVT include hemodynamic instability, thromboembolic events, congestive heart failure, exercise limitation, and decreased quality of life. Special considerations include missed diagnosis in neonates and infants, the association of SVT with congenital heart disease, and transition of care from pediatric to adult cardiology. Future directions and research may include advancements in genetic and molecular biomarkers and ablation methods. It is important to provide education and counseling to patients and their families, including information about the condition, treatment options, potential complications, and psychological support.

{"title":"Supraventricular tachycardia in children","authors":"Zoha Nizami , Phoebe Garcia , Paras Ahuja , Aaron James Nipper , Sachi Patel , Hridhay Sheth , Induja Gajendran , Reshvinder Dhillon","doi":"10.1016/j.ppedcard.2024.101771","DOIUrl":"10.1016/j.ppedcard.2024.101771","url":null,"abstract":"<div><h3>Background</h3><div>Supraventricular tachycardia (SVT) affects 1 in 500 children and is characterized by rapid heart rate originating from the atrial tissue above the atrioventricular node and interventricular septum.</div></div><div><h3>Aim of review</h3><div>The purpose of this article is to review the etiology, pathophysiology, types, clinical presentation, diagnosis, and treatment of SVT in children.</div></div><div><h3>Key scientific concepts of review</h3><div>SVT results from reentry circuits, abnormal automaticity, or triggered activity. Contributing factors include congenital heart defects, electrolyte imbalances, and genetic predisposition. The types of SVT include atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia, atrial tachycardia, and junctional ectopic tachycardia. Infants with SVT may present with poor feeding, vomiting, irritability, increased sleepiness, syncope, or diaphoresis. Toddlers and school-aged children may experience palpitations, chest pain, dizziness, shortness of breath, or syncope. Diagnostic tests include the electrocardiogram, Holter monitor, exercise stress test, and electrophysiologic study. Acute treatment options include vagal maneuvers, pharmacologic cardioversion, and electrical cardioversion. Long-term treatment options include antiarrhythmic drugs, catheter ablation, and surgical treatment. Complications of SVT include hemodynamic instability, thromboembolic events, congestive heart failure, exercise limitation, and decreased quality of life. Special considerations include missed diagnosis in neonates and infants, the association of SVT with congenital heart disease, and transition of care from pediatric to adult cardiology. Future directions and research may include advancements in genetic and molecular biomarkers and ablation methods. It is important to provide education and counseling to patients and their families, including information about the condition, treatment options, potential complications, and psychological support.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"76 ","pages":"Article 101771"},"PeriodicalIF":0.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143170222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Indications for cardiac anesthesia in children

IF 0.6 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2024-11-20 DOI: 10.1016/j.ppedcard.2024.101764

Karen S. Bender , Ryan Ford , Noel Godang , Connor Posey , Chase Smith , Gul Dadlani

Background

Children with congenital and acquired heart disease are at high risk for developing anesthesia-related cardiac arrest. Children with single ventricle physiology, left ventricular outflow tract obstruction, including Williams syndrome, cardiomyopathy, and pulmonary hypertension are at the highest risk for developing anesthesia-related cardiac arrest.

Aim of review

The purpose of this article is to review anesthesia in children with cardiovascular diseases, factors associated with anesthesia-related cardiac arrest, and treatment to decrease anesthesia-related mortality.

Key scientific concepts of review

Children with congenital heart disease have fewer complications and lower mortality when the anesthesiologist has specialized training and experience in pediatric cardiac anesthesia. Comprehensive evaluation before anesthesia includes a review of the patient, planned procedure, risks, and interventions for risk reduction. Admission for initiation of intravenous fluids at the start of fasting may be advised, potentially preventing risks associated with decreased preload from fasting. The anesthetic plan includes selection of agents and monitoring for induction, maintenance, emergence, and postanesthesia care. Patients with single ventricle physiology may require adjustments of pulmonary and systemic vascular resistance to optimize pulmonary and systemic blood flow. Left ventricular outflow tract obstruction may be subvalvular, valvular, or supravalvular, static or dynamic, and associated with an increased risk of perioperative cardiac events, including arrhythmias, myocardial ischemia, and heart failure. Patients with Williams syndrome may have supravalvular aortic stenosis, pulmonary artery stenosis, biventricular outflow tract disease, or coronary artery abnormalities; anesthesia typically includes intravenous induction and strategies to minimize blood pressure variation and tachycardia. In patients with pulmonary hypertension crisis under anesthesia, prompt treatment includes mild hyperventilation with 100 % oxygen and initiation of nitric oxide. Multidisciplinary collaboration between specialists, including anesthesiologists, cardiologists, surgeons, radiologists, and interventional specialists, may facilitate the development of the safest possible anesthetic plans.

{"title":"Indications for cardiac anesthesia in children","authors":"Karen S. Bender , Ryan Ford , Noel Godang , Connor Posey , Chase Smith , Gul Dadlani","doi":"10.1016/j.ppedcard.2024.101764","DOIUrl":"10.1016/j.ppedcard.2024.101764","url":null,"abstract":"<div><h3>Background</h3><div>Children with congenital and acquired heart disease are at high risk for developing anesthesia-related cardiac arrest. Children with single ventricle physiology, left ventricular outflow tract obstruction, including Williams syndrome, cardiomyopathy, and pulmonary hypertension are at the highest risk for developing anesthesia-related cardiac arrest.</div></div><div><h3>Aim of review</h3><div>The purpose of this article is to review anesthesia in children with cardiovascular diseases, factors associated with anesthesia-related cardiac arrest, and treatment to decrease anesthesia-related mortality.</div></div><div><h3>Key scientific concepts of review</h3><div>Children with congenital heart disease have fewer complications and lower mortality when the anesthesiologist has specialized training and experience in pediatric cardiac anesthesia. Comprehensive evaluation before anesthesia includes a review of the patient, planned procedure, risks, and interventions for risk reduction. Admission for initiation of intravenous fluids at the start of fasting may be advised, potentially preventing risks associated with decreased preload from fasting. The anesthetic plan includes selection of agents and monitoring for induction, maintenance, emergence, and postanesthesia care. Patients with single ventricle physiology may require adjustments of pulmonary and systemic vascular resistance to optimize pulmonary and systemic blood flow. Left ventricular outflow tract obstruction may be subvalvular, valvular, or supravalvular, static or dynamic, and associated with an increased risk of perioperative cardiac events, including arrhythmias, myocardial ischemia, and heart failure. Patients with Williams syndrome may have supravalvular aortic stenosis, pulmonary artery stenosis, biventricular outflow tract disease, or coronary artery abnormalities; anesthesia typically includes intravenous induction and strategies to minimize blood pressure variation and tachycardia. In patients with pulmonary hypertension crisis under anesthesia, prompt treatment includes mild hyperventilation with 100 % oxygen and initiation of nitric oxide. Multidisciplinary collaboration between specialists, including anesthesiologists, cardiologists, surgeons, radiologists, and interventional specialists, may facilitate the development of the safest possible anesthetic plans.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"76 ","pages":"Article 101764"},"PeriodicalIF":0.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143170223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment of patent foramen ovale in children and adolescents

IF 0.6 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2024-11-19 DOI: 10.1016/j.ppedcard.2024.101770

Eva Nunlist , Bijay Shrestha , Eru Sujakhu

Background

Patent foramen ovale is a fetal communication between the atria that is caused by incompetence of the valve of the oval fossa. It is a common incidental finding on echocardiography in about 25 % of adults.

Aim of review

The purpose of this article is to review patent foramen ovale in children and adolescents, associated clinical conditions, and treatment options.

Key scientific concepts of review

Patent foramen ovale can be associated with a range of morbidities, including migraine headaches, cryptogenic ischemic stroke, transient ischemic attack, paradoxical embolus, syncope, decompression sickness, and platypnea-orthodeoxia syndrome (a rare condition leading to dyspnea and hypoxemia when standing or sitting upright). Notably, a patent foramen ovale is more prevalent in patients having migraines with aura (50 %) than those without aura (27 %). Closure of patent foramen ovale has been observed to reduce the median number of migraine days, although it does not impact overall headache frequency. Patent foramen ovale, as a cardiac anomaly, is found in a significant proportion of pediatric stroke cases due to its potential for paradoxical emboli shunting to the brain. In the pediatric population, percutaneous patent foramen ovale closure is safe and, when combined with antiplatelet therapy, effectively reduces the risk of new brain infarcts and stroke recurrence. Young patients with sickle cell disease and patent foramen ovale have an increased risk of bleeding while on anticoagulation therapy; hence, transcatheter patent foramen ovale closure is preferable to prevent neurological sequelae. Additionally, there is evidence showing a four-fold higher frequency of syncope in patients with patent foramen ovale, suggesting a significant association. The 2020 American Academy of Neurology Practice Advisory recommends patent foramen ovale closure for secondary stroke prevention in patients under 60 with embolic strokes of unknown etiology. When clinically indicated, patent foramen ovale closure is a feasible and safe intervention in children and adolescents, promising to reduce stroke-related morbidity.

{"title":"Treatment of patent foramen ovale in children and adolescents","authors":"Eva Nunlist , Bijay Shrestha , Eru Sujakhu","doi":"10.1016/j.ppedcard.2024.101770","DOIUrl":"10.1016/j.ppedcard.2024.101770","url":null,"abstract":"<div><h3>Background</h3><div>Patent foramen ovale is a fetal communication between the atria that is caused by incompetence of the valve of the oval fossa. It is a common incidental finding on echocardiography in about 25 % of adults.</div></div><div><h3>Aim of review</h3><div>The purpose of this article is to review patent foramen ovale in children and adolescents, associated clinical conditions, and treatment options.</div></div><div><h3>Key scientific concepts of review</h3><div>Patent foramen ovale can be associated with a range of morbidities, including migraine headaches, cryptogenic ischemic stroke, transient ischemic attack, paradoxical embolus, syncope, decompression sickness, and platypnea-orthodeoxia syndrome (a rare condition leading to dyspnea and hypoxemia when standing or sitting upright). Notably, a patent foramen ovale is more prevalent in patients having migraines with aura (50 %) than those without aura (27 %). Closure of patent foramen ovale has been observed to reduce the median number of migraine days, although it does not impact overall headache frequency. Patent foramen ovale, as a cardiac anomaly, is found in a significant proportion of pediatric stroke cases due to its potential for paradoxical emboli shunting to the brain. In the pediatric population, percutaneous patent foramen ovale closure is safe and, when combined with antiplatelet therapy, effectively reduces the risk of new brain infarcts and stroke recurrence. Young patients with sickle cell disease and patent foramen ovale have an increased risk of bleeding while on anticoagulation therapy; hence, transcatheter patent foramen ovale closure is preferable to prevent neurological sequelae. Additionally, there is evidence showing a four-fold higher frequency of syncope in patients with patent foramen ovale, suggesting a significant association. The 2020 American Academy of Neurology Practice Advisory recommends patent foramen ovale closure for secondary stroke prevention in patients under 60 with embolic strokes of unknown etiology. When clinically indicated, patent foramen ovale closure is a feasible and safe intervention in children and adolescents, promising to reduce stroke-related morbidity.</div></div>","PeriodicalId":46028,"journal":{"name":"PROGRESS IN PEDIATRIC CARDIOLOGY","volume":"76 ","pages":"Article 101770"},"PeriodicalIF":0.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143170224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Infantile scimitar syndrome with severe pulmonary hypertension with novel 3p26 microdeletion/12q23–24 microduplication: Case report and literature review

IF 0.6 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2024-11-17 DOI: 10.1016/j.ppedcard.2024.101768

Junpei Kawamura , Yoshihiro Takahashi , Koji Nakae , Kentaro Ueno , Yukiko Tazaki , Ikeda Toshiro , Yasuhiro Okamoto

Infantile scimitar syndrome is a rare type of partial pulmonary venous return that is sometimes complicated by severe pulmonary hypertension, which has a poor prognosis. As the genetic background of Scimitar syndrome remains unclear, we report a case of an infant with scimitar syndrome that was analyzed using a chromosomal microarray. Fetal echocardiography revealed an abnormal return of the entire right pulmonary vein to the inferior vena cava. The patient presented with abnormal physical features and a history of atrial septal defects, multiple muscular ventricular septal defects, chronic pleural chylothorax, and hypertrophic pyloric stenosis. The patient died at the age of 3 months despite receiving multidisciplinary treatment with nitric oxide and a pulmonary vasodilator for severe pulmonary hypertension. Chromosomal microarray analysis revealed a copy number loss of 3p.26.1–26.3 (6.5 Mb), a copy number gain of 12q23.2–24.3 (30.8 Mb), and a determined karyotype of 46, XY, der (3) t (3;12) (p26.1;q23.2), arr [grch37] 3p26.1p26.3(62,199_6,541,934) x1,12q23.2q24.3(102,869,918_133,747,247) x3. We report a case of multiple malformations, including Scimitar syndrome and severe pulmonary hypertension with a novel unbalanced translocation involving a 3p26.1–26.3 microdeletion and a 12q23.2–24.3 microduplication. The relationship between unbalanced translocations and the phenotype and prognosis of scimitar syndrome requires further investigation.

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引用次数: 0

A novel approach to thrombectomy and catheter directed tissue-type plasminogen activator in a toddler post-fontan 为一名脑瘫后幼儿实施血栓切除术和导管引导组织型血浆蛋白酶原激活剂的新方法

IF 0.6 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2024-11-09 DOI: 10.1016/j.ppedcard.2024.101767

Vaishnavi Divya Nagarajan , Laura A. Miller-Smith , Yoshi O. Otaki , Ashok Muralidaran , Grant H. Burch , Laurie B. Armsby , Becky J. Riggs

16-month-old with single ventricle Glenn physiology underwent early placement of an extra-cardiac non-fenestrated Fontan. Post-operative course complicated by a nearly occlusive inferior vena cava thrombus and an intra-Fontan thrombus causing multiorgan system failure. Both thrombi were emergently removed with fluoroscopy, ultrasound, and computer guided clot-aspirator in the pediatric catheterization lab.

16个月大的单心室格伦患者，早期接受了心外无瘘丰坦手术。术后因几乎闭塞的下腔静脉血栓和导致多器官系统衰竭的丰坦内血栓而并发症。在儿科导管室通过透视、超声和计算机辅助血栓抽吸器紧急清除了这两个血栓。

引用次数: 0

Left ventricular pseudoaneurysm following balloon aortic valvuloplasty in a preterm neonate: Case report 早产新生儿球囊主动脉瓣成形术后的左心室假性动脉瘤：病例报告

IF 0.6 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2024-10-24 DOI: 10.1016/j.ppedcard.2024.101763

Theodore J. Millette , James J. Gangemi , Shelby C. White , Michael J. Shorofsky

Left ventricular aneurysms and pseudoaneurysms are rare in the pediatric population. We report a case of a preterm neonate with critical aortic valve stenosis who developed a left ventricular pseudoaneurysm and perforation following transcatheter balloon aortic valvuloplasty on day four of life. The possible etiologies of myocardial injury and the unique surgical repair technique are discussed.

左心室动脉瘤和假性动脉瘤在小儿中非常罕见。我们报告了一例患有重度主动脉瓣狭窄的早产新生儿，在出生后第四天接受经导管球囊主动脉瓣成形术后出现左心室假性动脉瘤和穿孔。本文讨论了心肌损伤的可能病因和独特的手术修复技术。

引用次数: 0

Fetal supraventricular tachycardia with giant cardiac rhabdomyoma: Role of post natal sirolimus in a developing country 胎儿室上性心动过速伴巨大心脏横纹肌瘤：产后西罗莫司在发展中国家的作用

IF 0.6 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2024-10-24 DOI: 10.1016/j.ppedcard.2024.101762

Anis Munirah Mohd Kori , Nursyahirah Anum Mohd Radzi , Ammar Mohamad Ziyadi , Intan Juliana Abd Hamid , Nor Rosidah Ibrahim , Noraida Ramli , Mohd Rizal Mohd Zain

Primary cardiac tumors in fetuses are rare and mainly represent rhabdomyoma. The tumors can be clinically silent or cause hemodynamically significant obstructions. We present a case of giant neonatal cardiac rhabdomyoma with right inflow obstruction complicated by fetal supraventricular tachycardia. Fetal echocardiography revealed the presence of supraventricular tachycardia with multiple cardiac masses, one of which caused an obstruction of the right inflow of the heart. As the baby developed hemodynamic instability due to the mass effect, oral sirolimus was initiated postnatally. Despite the limitation of evidence on the usage of sirolimus in neonatal population, this case report revealed the benefits of postnatal sirolimus in a decrease in the size of the mass without any adverse medication effects. Sirolimus has demonstrated efficacy in neonatal cardiac rhabdomyoma, however, a large prospective study is needed to demonstrate the efficacy.

胎儿的原发性心脏肿瘤非常罕见，主要是横纹肌瘤。这些肿瘤可能在临床上无症状，也可能导致血流动力学上的明显梗阻。我们报告了一例新生儿巨大心脏横纹肌瘤并发右心室流入道梗阻和胎儿室上性心动过速的病例。胎儿超声心动图显示，胎儿存在室上性心动过速和多个心脏肿块，其中一个肿块导致右心流入道梗阻。由于肿块效应导致婴儿血流动力学不稳定，产后开始口服西罗莫司。尽管在新生儿群体中使用西罗莫司的证据有限，但该病例报告显示了产后使用西罗莫司的益处，即在减少肿块大小的同时不会产生任何药物不良反应。西罗莫司对新生儿心脏横纹肌瘤有一定疗效，但还需要大型前瞻性研究来证明其疗效。

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引用次数: 0

It is a fine line with flecainide: A case of flecainide toxicity in a pediatric patient 非卡尼是一种微妙的药物：一例儿科非卡尼中毒病例

IF 0.6 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2024-10-18 DOI: 10.1016/j.ppedcard.2024.101761

Aura Daniella Santi-Turchi , Keerthana Banala , Michelle Jadotte , Sherrie Joy Baysa , Steven Fishberger

Flecainide is a class IC antiarrhythmic used in the treatment of supraventricular and ventricular tachyarrhythmias in the pediatric population. It has a narrow therapeutic index that requires careful dosing and monitoring of levels, as well as education on preparation and administration. Many different factors alter the bioavailability of this medication, and special consideration must be taken among pediatric patients. Clinical signs of toxicity include lethargy, bradycardia, altered mental status, and ventricular arrhythmias. Management of flecainide toxicity involves administering sodium bicarbonate as well as lipid emulsion therapy. We present the case of a child found to have flecainide toxicity and discuss management strategies.

氟卡尼是一种 IC 类抗心律失常药物，用于治疗儿童室上性和室性快速性心律失常。它的治疗指数较窄，需要谨慎给药和监测药物浓度，并进行配药和用药方面的教育。许多不同的因素会改变这种药物的生物利用度，因此必须特别考虑到儿科患者。中毒的临床表现包括嗜睡、心动过缓、精神状态改变和室性心律失常。处理非卡尼中毒的方法包括使用碳酸氢钠和脂质乳剂治疗。我们介绍了一例发现福卡尼中毒的患儿，并讨论了处理策略。

引用次数: 0

Migration of a pacemaker into the sigmoid colon in a three-year-old child: A case report 一名 3 岁儿童的心脏起搏器移入乙状结肠：病例报告

IF 0.6 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY

Pub Date : 2024-10-16 DOI: 10.1016/j.ppedcard.2024.101760

I.A. Soynov, A.N. Arkhipov, S.N. Manukian, D.A. Elesin, T.S. Khapaev, A.B. Romanov

Implantation of an epicardial pacemaker in young children is carried out in a pocket above the rectus muscle. In extremely rare cases, pediatric patients may experience migration of the pacemaker into the abdominal cavity. Symptoms can range from mild abdominal discomfort, diarrhea, vomiting to potentially dangerous intestinal obstruction due to perforation of the large intestine. We present a case of a 3-year-old child with migration of the pacemaker into the sigmoid colon with the formation of a colonic fistula. Early diagnosis helps to avoid serious complications in the case of pacemaker migration. Any change in the position of the pacemaker will indicate the need for pacemaker reimplantation to prevent life-threatening symptoms.

为幼儿植入心外膜起搏器是在直肌上方的口袋中进行的。在极少数情况下，小儿患者可能会出现起搏器移位到腹腔的情况。症状可能包括轻微的腹部不适、腹泻、呕吐，也可能因大肠穿孔而导致危险的肠梗阻。我们介绍了一例起搏器移位到乙状结肠并形成结肠瘘的 3 岁儿童病例。早期诊断有助于避免起搏器移位引起的严重并发症。起搏器位置的任何变化都表明需要重新植入起搏器，以防止出现危及生命的症状。

引用次数: 0

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