No abstract available.
Heart Diseases* ; Heart* ; Humans ; Infant*

Acute infectious myocarditis in children can be caused by many pathogens, including bacteria, viruses, fungi and protozoa. Patients may be asymptomatic or may have 'flu-like symptoms' to life-theratening arrhythmias or sudden death. We herein report a case of acute myocarditis complicated by complets and permanent AV block, associated with Salmonella group B gastroenteritis in a previously healthy 5-year-old boy. Presenting symptoms were dyspnea, cyanosis, vomiting, and diarrhea. Electrocardiography on admission showed very slow ventricular escape rhythm at 37 beats/minute. He was treated with antibiotics, inotropic agents, ventilatory support, and transvenous temporary pacemaker. Ten days later, permanent dual chamber pacemaker was implanted. All three consecutive stool cultures done after admission grew Salmonella group B. His ventricular function recovered rapidly and completely and he became fully active 2 months after the onset. However, his conduction system was totally destroyed and at last follw up evaluation 2 years after the onset, he is still totally dependent on the pacemaker without any escape rhythm.
Anti-Bacterial Agents ; Arrhythmias, Cardiac ; Atrioventricular Block* ; Bacteria ; Child ; Child, Preschool ; Cyanosis ; Death, Sudden ; Diarrhea ; Dyspnea ; Electrocardiography ; Fungi ; Gastroenteritis* ; Humans ; Male ; Myocarditis* ; Salmonella* ; United Nations ; Ventricular Function ; Vomiting

No abstract available.
Angiography* ; Heart Septal Defects, Ventricular* ; Pulmonary Artery* ; Pulmonary Atresia*

No Abstract available.
Angiotensin-Converting Enzyme Inhibitors* ; Angiotensins* ; Peptidyl-Dipeptidase A*

No abstract available.

Patients with atypical or incomplete Kawasaki disease are at same risk for development of coronary artery complications as typical Kawasaki disease. In this communication we report six patients with unusual presentation of Kawasaki disease complicated by coronary artery aneurysms, in whom correct diagnosis were not made in time for proper treatment. One of these patients died from massive myocardial ischemia due to giant aneurysms along the entire coronary artery system. These patients had either less than enough number of diagnostic criteria at initial presentation or diagnostic signs which occurred over an extended period of time, resulting in difficulty in diagnosis during the acute phase. As a result, none of these patients received intravenous gamma globulin treatment. Thus strict adherence to currently accepted criteria for diagnosis of Kawasaki disease may lead to failure to recognize atypical form of this illness with potential sequelae of myocardial ischemia or sudden death. We would like to emphasize from this experience that clinicians must be aware of the wide variations in clinical presentation of Kawasaki disease and take an aggressive approach in making correct diagnosis by obtaining early cardiac evaluation in order to initiate prompt treatment with intravenous gamma globulin.
Aneurysm ; Coronary Aneurysm* ; Coronary Vessels ; Death, Sudden ; Diagnosis ; gamma-Globulins ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Myocardial Ischemia

To examine the usefulness of cardiac MRI in assessing patients (pt) with congenital heart diseases(CHD), informations obtained from MRI and echocardiogrphy (echo) were compared in 91 consecutive pt with CHD and was correlated with findigs at cardiac catheterization (53pt) and at surgery (71pt). Pt were studied with 1.5 Tesla MRI unit and multiplanar images of the heart and great vessels were obtained using ECG-gated multislice spin-echo technique. Age ranged from newborn to 22 years. We obtained the following results. MRI was vary useful in providing important diagnostic informations in 19pt, provided informations which was not crucial to the clinical decision in 28pt, and did not provide additional informations in 44pt. MRI was very useful in assessing complex lesions, particularly in identifying atrial situs, rudimentary ventricular chamber, criss-cross atrioventricular connection, total anomalous pulmonary venous connection, anatomy of ventricular septal defect in double outlet right ventricle, anomalous ventricular muscles, aortopulmonary collateral artery and distal pulmonary artery anatomy. En face view of the ventricular septum was very useful in clearly outlining the ventricular septal defect. MRI gave false information in 17pt. Diagnostic accuracy of MRI was poor for coarctation of the aorta in neonates and small infants, patent ductus arteriosus and pulmonary stenosis. Cardiac MRI is recommended for preoperative planning in selected pt with CHD, particularly with complex lesions.
Aortic Coarctation ; Arteries ; Cardiac Catheterization ; Cardiac Catheters ; Double Outlet Right Ventricle ; Ductus Arteriosus, Patent ; Echocardiography* ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging* ; Muscles ; Pulmonary Artery ; Pulmonary Valve Stenosis ; Ventricular Septum

No abstract available.
Arrhythmias, Cardiac* ; Child* ; Humans

We performed clinical and virological studies on 79 children with hand, foot and mouth disease (HFMD) who had been admitted or visited to the department of Pediatrics, Asan Medical Center from February to August, 1990. The results were as follows; 1) There were total of 79 cases with hand, foot and mouth disease during this period. The aseptic meningitis was combined in 18 cases (22.8%). 2) The male-to-female ratio of HFMD was 2.03 to 1, but that of aseptic meningitis was 8 to 1. 3) Hand, foot and mouth disease occurred more frequently in under the age of 5 years, and the aseptic meningitis in under the age of 1 year. 4) Hand, foot and mouth disease and the aseptic meningitis occurred mostly in May and June. 5) In addition to the skin manifestations characteristic in hand, foot and mouth disease, some of the patients with aseptic meningitis had the following symptoms: change of consiousness, seizure, monoparesis in the upper extremity, paraparesis in the lower extremity. 6) The causative agent of hand, foot and mouth disease associated with the aseptic meningitis in Seoul in 1990 seemed to be enterovirus 71 according to the serologic study.
Animals ; Child ; Chungcheongnam-do ; Enterovirus ; Foot-and-Mouth Disease ; Hand* ; Hand, Foot and Mouth Disease* ; Humans ; Lower Extremity ; Meningitis, Aseptic* ; Paraparesis ; Paresis ; Pediatrics ; Seizures ; Seoul* ; Skin Manifestations ; Upper Extremity

No abstract available.
Child* ; Electrocardiography* ; Humans ; Tachycardia, Ventricular*