The foundation of neonatal arrhythmia is the immature heart conduction system. Common causes include neonatal organic heart disease (infectious myocarditis, myocardial injury, and congenital heart disease); neonatal infectious diseases; neonatal asphyxia; electrolyte imbalance, acidosis, and drug overdose. According to different arrhythmia (premature constractions,paroxysmal superventricular tachycardia,chaotic atrial tachycardia,completely conduction block),the patients should be treated in different measures. Managements include original disease treatment, removal of incentives, add with anfi-arrhythmic drugs, and protection of myocardial.

Objective To observe the clinical characteristics and improve the diagnosis and treatment of right coronary artery anomalies in children.Methods The clinical characteristics,laboratory examination,treatment and prognosis were retrospectively analyzed in children with right coronary artery anomalies (complex cardiac anomalies was excluded),who were admitted into Beijing Children's Hospital Affiliated to Capital Medical University from January 2009 to December 2014.Results A total of 8 medical records of children with right coronary artery anomalies,among whom 5 cases were male and 3 cases were female,with a mean age of (7.06 ± 1.37) years old.In these 8 patients,there were 5 patients with right coronary artery originating from left coronary sinus,1 patient with right coronary artery originating from left wall of aorta,1 patient with single left coronary artery type Lipton L Ⅱ,and 1 patient with right coronary artery absence.The main symptoms included chest distress,chest pain and palpitation in elder children,but in infants,the primary symptom was poor feeding.One case of these patients represented syncope.Electrocardiogram of these patients showed ST-T wave changes,sinoatrial block,and sinus arrest.Ultrasonic cardiogram failed to discover the coronary artery anomalies.Four cases showed enlarged left ventricular end-diastolic diameter,and 1 case showed slight decrease of left ventricular ejection function.All 8 patients were given myocardial tonic with limitation in doing exercise,and clinical follow-up studies were conducted for 6 months.Four patients with enlarged left ventricular were treated with Captopril,and 3 patients of them recovered after 3 to 6 months.Two patients with sinus node malfunction were treated with permanent pacemaker implantation in other hospitals.Conclusions Right coronary artery anomaly in children is rare.Patients with cardiac ischemia and sinus node malfunction should be aware of right coronary malformation.64-section multidetector computerized tomography angiography can diagnose right coronary artery anomalies.To patients with right coronary artery anomalies,vigorous exercises should be avoided to decrease adverse cardiac events.

Objective To investigate the differences of symptoms,physical signs and examinations in childhood and adult patients with Marfan syndrome.Methods Twenty-four children diagnosed as Marfan syndrome were investigated and evaluated synthetically in symptoms,physical signs and examinations.The positive rate of each item was analyzed to find the differences between childhood and adult patients.Results Among 24 patients,thorax and spinal deformity were found in 19 children(79%),leptosome type existed in 16 children(67%),dolichostenomelia was found in 15 children(63%).The dilation of the aortic sinus was detected in 16 children ((67%),)and the dilations of left ventricle and mitral regurgitation were found in 3 children(13%) with echocardiogram.Conclusions It is critical ascertain the abnormalities in cardiovascular system and give intervention,and it is expected to prolong the patients′ life by slowing down the changes in aortic walls.

Objective To study the clinical characteristics and therapy of children with idiopathic ventricular tachycardia(IVT).Method Clinical features,laboratory examination,treatment and outcomes of cases involving 36 children with IVT were retrospectively and statistically analysed.Results IVT often happened in teenagers.The average age of selected patients was 7 years and 8 months,and the ratio of male and female was 1.11.Electrokardiogram(EKG)results showed 23 cases(63.8%)were VT that arised from the left ventricular tachycardia(ILVT)with right bundle branch block,and 13 cases(36%)were VT that arise from the right ventricular outflow tract(RVOT VT)with left bundle branch block.Among the 23 children with tachycardia,15 children had palpitation,2 children had syncope.Of the 13 children with right ventricular tachycardia,3 children had increased heartbeat,and 1 child suffered from weakness,others had no significant clinical symptoms.Cases with ILVT had more serious clinical symptoms than cases with right ventricular tachycardia.It was of marked significance to compare their differences(P

Objective To study the clinical characteristics of children with chaotic atrial tachycardia (CAT),and to improve its clinical diagnosis and treatment.Methods Clinical data,follow-up,treatment and prognosis concerning 33 patients with CAT from Sep.2001 to Oct.2013 in Beijing Children's Hospital were analyzed.Results The 33 patients included 23 boys and 10 girls with ages ranging from 3 days to 13 months,5 months on the average.CAT was conformed by electrocardiogram in all patients:multifocal atrial tachycardia defined by 3 distinct P'-waveforms,irregular P'R,RR and P'-P' intervals,and isoelectric baseline between P'-waves.Combined with symptoms of atrial flutter,atrial fibrillation,atrial premature beats,atrial tachycardia,and interior conduction,differences were detected by 24-hour holter electrocardiography.Echocardiographic features indicated mild heart enlargement in 19 cases,medium enlargement in 4 cases,severe enlargement in 3 cases,atrial septal defect in 5 cases,ventricular septal defect in 3 cases,atrial septal defect coupled with patent ductus arteriosus in 1 case,congenital total anomalous pulmonary venous cormection in 1 case,and patent foramen ovale closure in 12 cases.Twenty-three patients had heart failure.Digoxine,amiodarone and Betaloc were administered to the patients for maintaining their heart functions.No antiarrhythmic drug therapy was used in 2 patients.Twenty-six of the patients (78.8％) had normal electrocardiographic sinus rhythm within 3 to 18 months after their discharge from hospital.Three of the patients (9.1％) still had CAT symptoms in their eletroccardiogram,but their heart rates were kept under control during the 12-month follow-up clinical visits.Of 26 children with cardiac enlargement,echocardiograms in 21 cases (80.8％) returned to normal within 1-3 months after their electrocardiograms returned to normal,and for the other 5 cases (19.2％),the recovery took 6-12 months.One patient died and 3 patients did not participate in the follow-up visits.Conclusions CAT is often found in newborns and infants.Its diagnosis relies on electrocardiography and 24-hour holter electrocardiography.Treatment with Digoxine,and/or β-receptor block,and amiodarone according to with the heart functions of patients can restore sinus rhythm,and achieve good prognostic results.

Hypertension in children is defined as systolic blood pressure and/ or diastolic blood pressure≥95th percentile for age,gender and height,on at least 3 occasions. Persistent hypertension despite non - pharmacologic measures should be treated with anti - hypertensive drugs. Angiotensin - converting enzyme inhibitors,angiotensin receptor blockers,calcium channel blockers,β - blockers and diuretics are safe,effective,and well tolerated in children. This article describes the selection and clinical application of anti - hypertensive drugs in children.

Objective To study the clinical characteristics and curing methods of non-compaction of ventricular myocardium(NVM) in children with a view to improve its diagnosis and treatment.Methods From Jan.2009 to Dec.2012,the clinical data,treatment and follow-up of 22 patients with NVM in Beijing Children's Hospital Affiliated to Capital Medical University were analyzed.Results The 22 patients included 13 boys and 9 girls aged from 4 months to 13 years and 3 months with an average age of 3 years and 7 months.Five of them had a family history of cardiac diease.Twenty patients suffered from ventricular dysfunction,with 2 cases at level Ⅰ,5 cases at level Ⅱ,7 cases at level Ⅲ and 6 cases at level Ⅳ.Asymptomatic heart murmur was heard in 6 patients and creatine kinase car-diac isoenzymes raise was found in 6 patients.X-ray indicated that heart shadow enlargement and electrocardiographic abnormalities in all 22 patients.Echocardiography features of all cases indicated left ventricular enlargement,and 20 cases of the children had ventricular systolic dysfunction.Left ventricle was detected in 21 patients,while double ventricle dysfunction detected in 1 patient.Thrombus was found in none of the patients.Magnetic resonance imaging was performed in 8 cases of the patients and CT was performed in 14 cases,all of them showed abnormalities.Anti-heart failure medications were administered to 20 patients and aspirin to all of the children.The patients were followed up for 0.5 to 3.0years.Two patients died from heart failure during the follow-up.In 2 cases whose cardiac ejection fraction was more than 60％ had little change of the internal diameter of left ventricle and cardiac function.In 3 cases,the left ventricular diameter narrowed by 3 to 5 millimeter and ejection fraction increased by 5％ to 10％ over the previous.In 5 cases,the left ventricular diameter expanded by 5 to 7 millimeter and ejection fraction decreased by 3％ to 5％.In 10 cases,the left ventricular diameter and heart function had no significant change.Conclusions The main clinical manifestions of NVM in children are cardiac dysfunction,and the prognosis is usually poor.Echocardiography is the principal means of diagnosis.Magnetic resonance imaging can contribute to the diagnosis.

Heart failure is a common critical disease in children.Systolic heart failure can be caused by common diseases in children such as congenital heart disease,fulminant myocarditis and arrhythmogenic cardiomyopathy.Positive inotropic drug is the most common medication for treating systolic heart failure in children.Common inotropic drug includes digitalis,β-receptor agonist,phosphodiesterase inhibitor and calcium sensitizers.This article reviewed the using and progress of positive inotopic drugs.

Objective To investigate the clinical characteristics,diagnosis,treatment and prognosis of hypertrophic cardiomyopathy(HCM) in children.Methods Twenty-five cases of children confirmed with HCM in Beijing Children's Hospital from October 2000 to September 2013 were analyzed retrospectively through their clinical manifestations,laboratory tests,treatment and prognosis.Results HCM was found to be more common in older children.The average age of the patients in the studied cases was 8 years and 9 months and the male to female ratio was 3.1:1.Their clinical manifestations were as the follows:5 cases with shortness of breath and fatigue,4 cases with chest tightness and long breath,3 cases with precordial discomfort,5 cases with cough and wheezing and found to have cardiac abnormalities,8 cases found with asymptomatic heart murmurs with no other symptom,2 cases with syncope episodes,6 cases with a clear HCM family history,3 cases with a family history of infant deaths (specific condition not clear).ECG:18 cases showing left ventricular and/or right ventricular hypertrophy and ST-T changes,3 cases showing abnormal Q waves,2 cases showing ST-T changes,2 cases with Ⅰ ° atrio-ventricular block,1 case with left bundle branch block,and 1 case with left anterior division block.Cardiac enzymes were elevated in 5 cases.Chest X-rays showed enlarged heart shadow in 17 cases.Echocardiography revealed non-obstructive hypertrophic cardiomyopathy in 23 cases and obstructive hypertrophic cardiomyopathy in 2 cases.Left ventricular systolic function was decreased in 2 cases,and diastolic dysfunction in 3 cases.Twenty-one patients took oral metoprolol,1 patient took verapamil,1 patient took propranolol and 2 patients took no medication.The follow-up period of 2 months to 13 years witnessed 2 cases of death and 23 cases of survival.Conclusion HCM in children lacks specific clinical manifestations and the conditions of the patient are usually severe with progressive development.HCM is one of the main reasons of sudden death in adolescent,with poor prognosis.

Mammal multidrug and toxin extrusion proteins (MATEs) play an important role in the transport of organic cations in the body. MATEs mediate the final excretion step for multiple organic cation drug used clinically and important endogenous substances. This article reviews the discovery, type, gene coding and polymorphism, body distribution, classification of substrates and inhibitors and their research method of MATEs. The article also discusses the major research significance of MATEs with examples.
Animals ; Biological Transport ; Cations ; Organic Cation Transport Proteins ; metabolism ; Polymorphism, Genetic