Atrial fibrillation (AF), the most common chronic arrhythmia in adults, is rarely reported in children. Moreover, most of the previously reported children with AF have comorbidities, such as structural heart diseases, rheumatic diseases, and thyroid diseases. This case report is about a healthy 9-year-old boy who was diagnosed with AF without cardiac anomaly. He visited the emergency department with chest pain and palpitation, lasting 2 hours. His electrocardiogram showed narrow-complex tachycardia, which led to the diagnosis of supraventricular tachycardia. The administration of adenosine revealed rapid irregular P waves. After electrical cardioversion, cardiac rhythm was converted to normal sinus rhythm. This case report suggests that when children with narrow-complex tachycardia visit the emergency department, the possibility of AF, in addition to supraventricular tachycardia, should be considered if the RR intervals are markedly irregular.
Adenosine ; Adult ; Arrhythmias, Cardiac ; Atrial Fibrillation ; Cardiovascular Diseases ; Chest Pain ; Child ; Comorbidity ; Diagnosis ; Electric Countershock ; Electrocardiography ; Emergency Service, Hospital ; Humans ; Male ; Pediatrics ; Rheumatic Heart Disease ; Tachycardia ; Tachycardia, Supraventricular ; Thyroid Diseases

Female ; Heart Atria ; pathology ; Humans ; Middle Aged ; Pleural Effusion ; diagnosis ; diagnostic imaging ; Radiography ; Rheumatic Heart Disease ; diagnosis ; diagnostic imaging

Background:Rheumatic heart disease is an acquired heart disease which often seen in the year of 90's. Nowaday, due to the development of health care system, population benefit much of knowledge to prevent this disease, the rate of prevenlence reduce significant. Objectives:This study aims to diagnose and prevent relapse in childen with rheumatic heart diseasewho treated in National Hospital for Pediatrict. Subjects and method:A retrospective study was conducted on 236 children with rheumatic heart diseaseor cardiac valve diseasewho admitted at Cardiology department of the National Hospital for Pediatrics from 1st January 2001 to December 31, 2005. Results:29.7% (70/236) were hospitalized for rheumatic valve disease. Among 166 hospitalized children due to continuous rheumatic heart disease, the result showed that: The types of carditis and arthritis were the most frequent and at least 22.9% (38/166) of children had definitive permanent valve lesions . 65.7% (44/76 responses) children received proper prevention. Some of them were not monitored at the center of prevention. The greater part of the rest had no knowledge of this disease. Conclusion:Rheumatic heart disease reduced but the prevalence of heart valve complication increased.\r\n", u'\r\n', u'
Rheumatic Heart Disease/ diagnosis ; therapy ; Infant

Adult ; Female ; Humans ; Intracranial Embolism ; diagnosis ; therapy ; Pregnancy ; Pregnancy Complications, Cardiovascular ; diagnosis ; therapy ; Rheumatic Fever ; diagnosis ; therapy ; Rheumatic Heart Disease ; diagnosis ; therapy ; Sacroiliac Joint

diagnosis and management. Despite the decrease in rheumatic heart disease and the improvements in antibiotic prophylaxis, infective endocarditis has been reported with increasing frequency in the last few decades. Presumably, this is due to the rise in the incidence of intravenous drug users, carriers of prosthetic valves and other intracardiac devices, and the longer survival of patients with congenital heart disease. Despite the great advances in medical and surgical treatment, infective endocarditis is still a life-threatening disease with an estimated mortality of 27%. Infective endocarditis represents one of the few potentially fatal infections that may occur in a dental patient. Efforts to reduce the incidence of this disease usually take the form of appropriate antibiotic coverage before dental treatment, together with the establishment and maintenance of good oral health. This study is a case report of a patient who developed infective endocarditis after multiple tooth extractions due to chronic periodontitis of dental origin.]]>
Antibiotic Prophylaxis ; Chronic Periodontitis ; Diagnosis ; Drug Users ; Endocarditis ; Heart Defects, Congenital ; Humans ; Incidence ; Mortality ; Oral Health ; Rheumatic Heart Disease ; Tooth Extraction

In this study, a medical diagnosis decision support system based on hybrid genetic algorithm has been established to support the diagnosis of five common heart diseases (coronary heart disease, rheumatic valvular heart disease, hypertensive heart disease, chronic cor pulmonale and congenital heart disease). A heart disease database consisting of 352 samples was used for constructing and testing the performance of system. Cross-validation of the experimental results indicate that the system we established shows high capability of classifying these five kinds of heart diseases, the mean accuracy of classification is as high as 90.6%, and the user accuracy and procedure accuracy of each disease are both above 85.0%, showing great application prospect of supporting heart diseases diagnosis in clinics.
Algorithms ; Coronary Disease ; diagnosis ; Decision Support Systems, Clinical ; Decision Trees ; Diagnostic Techniques, Cardiovascular ; Heart Diseases ; diagnosis ; genetics ; Humans ; Pulmonary Heart Disease ; diagnosis ; Rheumatic Heart Disease ; diagnosis

BACKGROUND AND OBJECTIVES: The proportion of mitral regurgitation caused by chordae rupture has recently been seen to be increasing, as has the role of mitral valve repair in the treatment of chordae rupture. This study evaluated the clinical characteristics and trends of surgical treatment of chordae rupture. Additionally, we attempted to discern the usefulness of transthoracic echocardiography (TTE) in the preoperative diagnosis of chordae rupture. SUBJECTS AND METHODS: Forty patients (20 men, mean age:49+/-14) presenting with chordae rupture confirmed during surgery between January 1994 and April 2001 were included in this study. Clinical, TTE and surgical data were analyzed retrospectively. RESULTS: The cause of chordae rupture was idiopathic degeneration in 28 cases, rheumatic heart disease in 5, infective endocarditis in 6, and trauma in 1 case. The sites of rupture were the anterior leaflet (14), posterior leaflet (23), and anterior and posterior leaflets (3). Mitral valve repair was performed in 20 cases and mitral valve replacement was performed in 20 cases. Most mitral valve repairs were performed beginning in 1998 (17/20). Chordae rupture diagnosed by TTE numbered 14 cases (35%). CONCLUSION: Regurgitation caused by chordae rupture was primarily associated with idiopathic degenerative change. Posterior leaflet rupture was more frequent than anterior leaflet rupture. The use of mitral valve repair has been increasing since 1998.
Chordae Tendineae ; Diagnosis ; Echocardiography ; Endocarditis ; Humans ; Male ; Mitral Valve ; Mitral Valve Insufficiency ; Retrospective Studies ; Rheumatic Heart Disease ; Rupture*

PURPOSE: Infective endocarditis (IE) is a serious complication in children with structural heart disease. We reviewed 35 cases of IE to identify the recent changes in the pattern of preexisting heart diseases, the spectrum of causative organisms and prognosis. METHODS: The clinical records of children diagnosed as IE at the Seoul National University Children's Hospital from January 1987 through December 1997, were reviewed retrospectively. Duke criteria was used for diagnosis. Cases were categorized into primary group(PG) IE in an unoperated heart and post operative group(POG), and the latter further into early POG(within 2 months after operation) and late POG. RESULTS: There were 35 cases of IE developed in 34 patients; 18 cases in the PG, 6 cases in the early POG, and 11 cases in the late POG. Male to female ratio was 16 : 19. Mean age of POG, especially early POG was less than that of PG (early POG : late POG : PG=1.65 years : 6.5 years : 8.34 years, P=0.0267). Preexisting heart diseases were identified in 30 cases; rheumatic heart disease 1 case and congenital heart disease (CHD) 29 cases. Causative organisms were identified in 80%; viridans streptococci, 10 cases (33.3%); pneumococci, 2 cases; Group-D streptococci, 3 cases; staphylococci, 8 cases; Gram (-) organisms, 5 cases and Candida albicans, 2 cases. Vegetation was detected in 88.9% of PG and 64.7% of POG. The most common indication for surgery was uncontrolled infection, which were required in 9 cases. The overall mortality rate was 12.1%. Mortality in POG was higher than that of PG (23.5% versus 0%, P=0.033). CONCLUSION: The discrepancy of mean age among patient groups and the high proportion of patients belonging to POG, were consistent with the increase in the number of newly risky population that survived after cardiac surgery. A more aggressive consideration for operative management may improve the treatment results.
Candida albicans ; Child* ; Diagnosis ; Endocarditis* ; Female ; Heart ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Male ; Mortality ; Prognosis ; Retrospective Studies ; Rheumatic Heart Disease ; Seoul ; Thoracic Surgery ; Viridans Streptococci

BACKGROUND AND OBJECTIVES: The clinical pattern of infective endocarditis is constantly changing. Diagnosis and treatment of infective endocarditis were developed by recent diagnostic strategy (Duke criteria) and introduction of transesophageal echocardiography. The aim of this study was to compare the clinical character-istics of infective endocarditis in Sejong hospital to the previous report and was to investigate risk factor of heart failure, embolism and death. MATERIAL AND METHODS: All episodes hospitalized of infective endocarditis from January of 1990 to October of 1999 in Sejong hospital were reviewed retrospectively. The total cases of infective endocarditis was 80 cases in 78 patients. RESULTS: The male to female ratio was 1:1.05 (39 male, 41 female). The mean age was 42 years. Rheumatic heart disease was the most common predisposing heart disease in 28.8%, followed by prosthetic valve endocarditis. Streptococci were the most commonly isolated micro-organisms in 18 cases (45.0%), followed by staphylococci in 11 cases. Transesophageal echocardiography has a higher sensitivity than transthoracic echocardiography for detection of vegetation, abscess and paravalvular complication in endocarditis. In patients with echocardiographic vegetation and involvement of aortic valve, there was a statistically significant increase in the risk of heart failure. The factor that was associated with a statistically significant increase in the overall risk of embolization was not exist. Ten patients died (12.5%). Risk factor for death was left ventricular dysfunction. The incidence of death was more higher in patients with abscess and non-streptococcal endocarditis. CONCLUSION: Compared to the 1980's report, we observed increased mean age of patients, the decreasing trend of rheumatic heart disease as a predisposing heart disease and the decreasing incidence of streptococci as causative microorganism. Risk factors for congestive heart failure were aortic valve endocarditis and endocarditis with vegetation. Risk factor for death was left ventricular dysfunction.
Abscess ; Aortic Valve ; Diagnosis ; Echocardiography ; Echocardiography, Transesophageal ; Embolism ; Endocarditis* ; Female ; Heart Diseases ; Heart Failure ; Humans ; Incidence ; Male ; Retrospective Studies ; Rheumatic Heart Disease ; Risk Factors ; Ventricular Dysfunction, Left

BACKGROUND: The changes in the epidemiology of native valve endocarditis have been known in western countries recent years due to the decrease in the inci-dence of rheumatic heart disease, increased longevity of patients with valvular or congenital heart diseases, and the increase in degenerative heart disease due to the in-crease in the average life span of the general popula-tion. In this study, we analyzed and compared the epide-miological and clinical characteristics of patients with na-tive valvular endocarditis fro two different time periods. METHODS: We compared native valve endocarditis patients diagnosed from 1979 - 1984(group I) with those diagnosed from 1991 - 1996(group II). We used modified Duke' s criteria for the diagnosis and statistical analysis was done using SPSS window program. RESULTS: In our study, mean age of the population was higher in group II and significantly larger number of patients were over the age of 50 in group II. Involve-ment of multiple valves with vegetations and peri-valvular abscess were found more frequently in group II. Also, significantly higher percentage of patients from group II underwent surgical treatment. CONCLUSION: The results of this study suggest that the epidemiolocaland clinical characteristics of infective endocarsitis in Korea may change to resemble those in western countries. Further studies regarding this subject are needed.
Abscess ; Diagnosis ; Endocarditis* ; Epidemiology ; Heart Diseases ; Humans ; Korea ; Longevity ; Rheumatic Heart Disease