Pediatric vertigo presents with complex etiologies, and its clinical diagnosis and management can be challenging due to children's limited ability to describe their symptoms. Recurrent vertigo episodes in children, who are at a critical stage of development, can readily lead to emotional disorders in both the children themselves and their guardians. This article reports a case of benign paroxysmal vertigo of childhood（BPVC） in a child who sought care from multiple providers. The child was found to have a patent foramen ovale（PFO） and mild emotional disorder. By analyzing challenges encountered during the diagnostic and management process in this case of recurrent pediatric vertigo, this study provides practical guidance for rational selection of diagnostic techniques and the comprehensive assessment of disease status in pediatric vertigo/dizziness.
Child ; Humans ; Affective Symptoms/complications* ; Foramen Ovale, Patent/complications* ; Vertigo/complications*

PURPOSE: To compare the effectiveness of device closure and medical therapy in prevention of recurrent embolic event in the Korean population with cryptogenic stroke and patent foramen ovale (PFO). MATERIALS AND METHODS: Consecutive 164 patients (men: 126 patients, mean age: 48.1 years, closure group: 72 patients, medical group: 92 patients) were enrolled. The primary end point was a composite of death, stroke, transient ischemic attack (TIA), or peripheral embolism. RESULTS: Baseline characteristics were similar in the two groups, except age, which was higher in the medical group (45.3±9.8 vs. 50.2±6.1, p<0.0001), and risk of paradoxical embolism score, which was higher in the closure group (6.2±1.6 vs. 5.7±1.3, p=0.026). On echocardiography, large right-to-left shunt (81.9% vs. 63.0%, p=0.009) and shunt at rest/septal hypermobility (61.1% vs. 23.9%, p<0.0001) were more common in the closure group. The device was successfully implanted in 71 (98.6%) patients. The primary end point occurred in 2 patients (2 TIA, 2.8%) in the closure group and in 2 (1 death, 1 stroke, 2.2%) in the medical group. Event-free survival rate did not differ between the two groups. CONCLUSION: Compared to medical therapy, device closure of PFO in patients with cryptogenic stroke did not show difference in reduction of recurrent embolic events in the real world's setting. However, considering high risk of echocardiographic findings in the closure group, further investigation of the role of PFO closure in the Asian population is needed.
Adult ; Aged ; Aged, 80 and over ; Cardiac Catheterization/adverse effects ; Disease-Free Survival ; Embolism/etiology/*prevention & control ; Female ; Fibrinolytic Agents/adverse effects/*therapeutic use ; Foramen Ovale, Patent/complications/*drug therapy/mortality/*surgery ; Humans ; Ischemic Attack, Transient/*drug therapy/mortality/*surgery ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Risk ; Secondary Prevention/methods ; *Septal Occluder Device/adverse effects ; Stroke/etiology/prevention & control ; Treatment Outcome

Acute myocardial infarction is one of the conditions frequently managed in the emergency department. There are many complications associated with right ventricular infarction, and the incidence of right ventricular infarction associated with inferior myocardial infarction is as high as 51% based on electrocardiographic findings. We herein report the case of a 45-year-old Chinese man with inferior myocardial infarction complicated by right ventricular failure. He had hypoxaemia refractory to supplemental oxygen due to an acute right-to-left shunting through a patent foramen ovale (PFO). He underwent coronary angioplasty and closure of the PFO. It is crucial for the attending physician to consider the presence of a right-to-left shunt when there is persistent uncorrectable hypoxaemia despite maximal oxygen supplementation in the setting of right ventricular infarction, as there are clinical implications and certain clinical managing principles that should be applied.
Angioplasty, Balloon, Coronary ; Electrocardiography ; Foramen Ovale, Patent ; complications ; diagnosis ; Heart Failure ; complications ; Humans ; Hypoxia ; diagnosis ; Male ; Middle Aged ; Myocardial Infarction ; complications ; Oxygen ; therapeutic use ; Pulmonary Embolism ; complications ; diagnosis ; Ventricular Dysfunction, Right ; complications

Foramen Ovale, Patent ; pathology ; Humans ; Hypoxia ; complications ; etiology ; Male ; Middle Aged ; Myocardial Infarction ; diagnosis ; etiology ; physiopathology ; Singapore ; Ventricular Dysfunction, Right ; physiopathology

Air embolism is a rare complication of percutaneous nephrolithotomy. Patent foramen ovale, which is necessary in fetal circulation, is a potential route for emboli arising from the venous system to enter the systemic arterial circulation, resulting in paradoxical air embolism syndrome. A case of paradoxical air embolism during percutaneous nephrolithotomy is presented. To our knowledge, this is the first report of paradoxical air embolism associated with patent foramen ovale during percutaneous nephrolithotomy.
Adult ; Diverticulum/surgery ; Embolism, Air/*etiology ; Embolism, Paradoxical/*etiology ; Foramen Ovale, Patent/complications/surgery ; Humans ; Intraoperative Complications/*etiology ; Male ; Nephrostomy, Percutaneous/*adverse effects

From May, 1975 to August, 1986, we experienced 21 patients with ruptured aneurysm of the sinus of Valsalva. 1) Their ages ranged from 15 to 52 years with a mean age of 26.7 years, and 14 patients were male and 7 patients were female. Among 18 cases of which aneurysms occurred on the right sinus of Valsalva, 15 cases (83%) ruptured into the right ventricle, 1 case (6%) ruptured into the right atrium and 2 cases (11%) ruptured into the pulmonary artery. All 3 cases of which aneurysms occurred on the noncoronary sinus ruptured into the right atrium. 2) Clinical symptoms consisted of dyspnea (95%), palpitation (81%), chest pain (43%), orthopnea (33%), cough (14%), hemoptysis (5%), oliguria (5%), and fever (5%). In all patients continuous heart murmur was audible. Hepatomegaly (48%), pulmonary basal rale (14%), and pretibial pitting edema (19%) were also observed. 3) In all patients diagnosis was made with cardiac catheterization and angiography, and confirmed by operation excetpt one case. 4) Among 20 patients who had been performed corrective surgery, ventricular septal defect was observed in 16 patients (85%), aortic insufficiency in 5 patients (25%), pulmonary infundibular stenosis in 1 patient (5%), patent foramen ovale in 1 patient (5%), and tricuspid insufficiency in 1 patient (5%). Ventricular septal defect was observed in all 16 patients whose aneurysms of the right coronary sinus of Valsalva ruptured into the right ventricle and the pulmonary artery. 5) All patients survived operation, and no postoperative complication was found except 1 patient to whom reoperation was performed because of postoperative aortic insufficiency and detachment of the patch closure for ventricular septal defect. There was symptomatic improvement in all patients.
Aneurysm ; Aneurysm, Ruptured* ; Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Coronary Sinus ; Cough ; Diagnosis ; Dyspnea ; Edema ; Female ; Fever ; Foramen Ovale, Patent ; Heart Atria ; Heart Murmurs ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Hemoptysis ; Hepatomegaly ; Humans ; Male ; Oliguria ; Postoperative Complications ; Pulmonary Artery ; Pulmonary Subvalvular Stenosis ; Reoperation ; Respiratory Sounds ; Sinus of Valsalva*

Ventricular septal defects is most common congenital cardiac anomaly in Korea and worldwide. And its clinical spectrum is well known. The anatomic classification had been undertaken by several authors, but recently Dr. Soto and Anderson's classification is widely used instead of Dr. Kirklin's it. From April, 1984 to December 1986, 99 cases of ventricular septal defects had been taken surgical repair under direct vision using conventional cardiopulmonary bypass technique at Yeungnam university hospital. The clinical spectrum was similar to other hospital, and postoperative mortality was 2%, the most common associated anomaly was patent foramen ovale, and the most common postoperative complication was incomplete or complete right bundle branch block. The rank of defects was as followings: 45 perimembranous inlet type, 21 doubly committed subarterial type, 17, perimembranous trabecular type, and 16 perimembranous outlet type. There was no muscular and mixed type.
Bays ; Bundle-Branch Block ; Cardiopulmonary Bypass ; Classification* ; Foramen Ovale, Patent ; Heart Septal Defects, Ventricular* ; Korea ; Mortality ; Postoperative Complications