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

BACKGROUND: To get the information about the clinical characteristics of the paroxysmal junctional tachycardia in children and to get the general principle in managing these children. METHOD: Analysis of the medical records of the 43 patients(male 30, female 13) with paroxysmal junctional tachycardia(JT) who had been followed-up in this hospital for a mean of 4.6 years(range 1 month up to 12 years) was done. RESULT: In 19 patients, JT started before 1 years of age : in 2, during gestational period, in 15, within 4 months of age, in 2, after 4 months of age. The next peak was 7 in the age of 5 years. The associated cardiac abnormalities were complex congenital defects in 2, tumor in 1, dilated and hypertrophic cardiomyopathy in 1 each. The significant hemodynamic disturbances during JT were noticed in 25. Among those whose surface electrocardiogram during JT were available, mean heart rate during JT was 232rpm(range 160-310) ; narrow QRS complex in 33 and wide in 1 ; P` wave in ST segment or T wave in 22. The delta waves were noticed after stopping JT and during followe up in 20. The types of delta waves were A in 7, B in 9, and indeterminate in 4. The different forms of delta waves unrelated to the degree of fusion were noticed in 6 ; disappearance or intermittent form of delta wave in 4. The efficacy of stopping JT was as follows : ATP 84.4%(38/45), diving reflex 50%(7/14), other vagal stimulation 71.4%(5/7), digoxin 72.7%(8/11), verapamil 54.5%(12/22), D/C cardioversion 62.5%(5/8), neosynephrine 100%(2/2). There were 2 deaths due to associated cardiac defects and 2 elective catheter ablations during the followe up period. The preventive medication with digoxin, beta blocker, and/or verapamil was succesful in 14, partially succesful in 11, failed in 14. The 7 persistent JT were treated with amiodarone in 3, with amiodarone and beta blocker in 1, with flecainide and digoxin in 1. In 1, surgical ablation of accessory pathway was done due to persistent JT. At present, JT do not recur or occur transiently without drugs in 29 ; with drugs, JT become controlled without recurrence in 4, with transient episodes in 4 and with intermittent episodes in 1. CONCLUSION: Althouh the JT in children is benign in most cases spite of the severity during the early period, JT is persistent in cases and needs potent drugs to control JT. Ablation of the foci may be necessary in these cases. Even in patients whose long-term results are benign, it is necessary to choose the optimal drugs to terminate and prevent the JT during the intervening period.
Adenosine Triphosphate ; Amiodarone ; Cardiomyopathy, Hypertrophic ; Catheters ; Child* ; Congenital Abnormalities ; Digoxin ; Diving ; Electric Countershock ; Electrocardiography ; Female ; Flecainide ; Heart Rate ; Hemodynamics ; Humans ; Medical Records ; Phenylephrine ; Recurrence ; Reflex ; Tachycardia* ; Verapamil

A statistical comparison of pulmonary artery and pulmonary venous wedge pressure has been made by the correlation coefficient method in 24 children with various congenital heart disease. None of them had pulmonary hypertension above the normal range. During the systolic phase, pulmonary arterial pressure was 2.02+/-2.64mmHg greater than pulmonary venous wedge pressure with poor correlation(r=0.57). During the diastolic phase, pulmonary venous wedge pressure was 2.08+/-2.47mmHg greater than pulmonary aetery pressure with poor correlation(r=-.63). Mean pulmonary arterial pressure was 0.79+/-1.02mmHg greater than pulmonary venous wedge pressure with good correlation (r=0.96). Therefore, it is concluded that if pulmonary artery is not entered, a pulmonary vein wedge pressure is a useful indication of pulmonary artery mean pressure in selected cases of congenital heart disease.
Arterial Pressure ; Child ; Heart Defects, Congenital* ; Humans ; Hypertension, Pulmonary ; Pulmonary Artery* ; Pulmonary Veins ; Pulmonary Wedge Pressure* ; Reference Values

No abstract available.
Ductus Arteriosus, Patent*

No abstract available.
Child ; Coronary Vessels* ; Echocardiography ; Humans

A case of unilateral pulmonary vein atresia with absent right superior vena cava in 9 years-old boy is described with a discussion. Clinical findings were similar to other reports and consisted of hemoptysis, dyspnea and anemia. A chest X-rary revealed irregular vascular marking on left lung fiedld and increased interstitial marking on right upper lung field. The diagnosis could be confirmed with radionuclide perfusion study, MRI scan of heart and great vessels and angiography which demonstrated a small right pulmonary artery, pruned its peipheral branches, stasis of contrast material and nonvisualization of draining righ pulmonary veins. Pneumonectomy, patch angioplasty of diaphargm excision will be necessary.
Anemia ; Angiography ; Angioplasty ; Child ; Diagnosis ; Dyspnea ; Heart ; Hemoptysis ; Humans ; Lung ; Magnetic Resonance Imaging ; Male ; Perfusion ; Pneumonectomy ; Pulmonary Artery ; Pulmonary Veins* ; Thorax ; Vena Cava, Superior*

No abstract available.
Arteries*

No abstract available.

No abstract available.
Aneurysm* ; Coronary Vessels* ; Mucocutaneous Lymph Node Syndrome*

No abstract available.
Child ; Humans