Cardiac injury from an air gun pellet: a case report.

Air guns are tools which each day become more powerful serious or even fatal accidents are caused by them. We report the clinical case of a 10-year old patient who received an accidental shot puncturing the right auricle, with generation of an important hemopericardium. A favorable evolution followed conservative treatment. However, we want to emphasize the potential gravity of injuries caused by this type of weapon.

[The tilt-table test in assessing syncope of unknown origin: do differences exist between children and adults?]. / El test de basculación en la evaluación del síncope de origen desconocido: existen diferencias entre niños y adultos?

BACKGROUND AND OBJECTIVES: Little is known about the differences between children and adults in the results of head-up tilt test. This study sought to investigate the potential differences concerning: a) the clinical profile and circumstances of spontaneous syncope; b) the overall diagnostic performance of the test, and c) the type of positive response obtained. MATERIAL AND METHODS: We studied 31 children and 123 adults with unexplained syncope. If baseline test (tilting at 70 degrees for 30 min) resulted negative, it was repeated under isoprenaline low-dose infusion. RESULTS: There were no differences in either clinical profile, except for severe traumatism more frequent in adults (25% vs. 3% in children; p < 0.05), or overall diagnostic performance (39% in children vs. 33% in adults; p = NS). However, the way the test rendered positive (via basal tilting in 92% of children vs. 50% in adults; p < 0.05) and the rate of cardioinhibitory response (42% in children vs 8% in adults; p < 0.01) were significantly different. CONCLUSIONS: In this study children, in contrast to adults, rarely have a positive response in tilting under isoprenaline infusion. They also present a much higher rate of cardio-inhibitory response than adults.

[Prophylaxis of bacterial endocarditis in children with congenital heart disease: current status of parents' knowledge]. / Profilaxis de endocarditis bacteriana en niños con cardiopatía congénita: Estado actual de conocimientos por parte de los padres.

OBJECTIVE: The purpose of this study was to assess the knowledge that parents of children with congenital cardiac disease have about bacterial endocarditis (EB) and its prophylaxis (PEB). PATIENTS AND METHODS: To this end, an elusive questionnaire was prepared and offered to one hundred parents of children who needed PEB. The group was classified according to the age of the children, the cultural level of the parents an the event of a dental or if another septic focus was known in the past. Likewise, the parents' knowledge of their child's disease was analyzed. RESULTS: Of the results obtained, it stood-out that the parents appeared well informed about their child's illness, but their information was insufficient in relationship to EB and PEB. Of those tested, 85% defined the child's heart disease, while only 14% did so for EB. Likewise, only 67.7% of the children who underwent an intervention for a septic focus performed PEB correctly. The knowledge of this theme are in relationship to the family's cultural formation. CONCLUSIONS: We emphasize the need to reinforce the information about PEB that the cardiologists, pediatricians and general physicians give to the families in order to prevent the morbidity and mortality caused by EB.

[Aortico-left ventricular tunnel. Clinical and surgical considerations]. / Túnel aortoventricular izquierdo. Consideraciones clínicas y quirúrgicas.

We report the case of an infant operated on at 11 months, having been clinically, echocardiographically and hemodynamically diagnosed when 2 days at the age. In the Echo-Doppler study the visualisation of the tunnel and the presence of aortic regurgitation within it and in the left ventricular outflow tract confirmed the diagnosis. Surgical access to both orifices, aortic and left ventricular, through the tunnel (after incision in the same) allowed it to be closed with two Goretex patches from its external face. This technique has a double advantage: a) it avoids annular distortions or aortic valvular lesions, b) excluding the tunnel (partial resection of edges and subsequent continuous suture) any possibility of subpulmonary stenosis through compression is eradicated.

[Transluminal angioplasty for aortic coarctation in newborns and infants]. / Angioplastia transluminal en la coartación aórtica del recién nacido y lactante.

It has been done transluminal angioplastic with catheter balloon in 14 patients who are under 1 year of age and who are affected by aortic coarctation. For this study, they were divided in two groups. The first one was formed by newborn children whose transcoarctation gradient was 52 mm Hg in average. The second group was integrated by 9 newborn children whose transcoarctation gradient was 59 mm Hg. After this experience was done the gradient descended to 9 and 15 mm Hg respectively. Twenty four hours later, two months later and over two more months, there were follow-up of the clinical situation, the evolution of the pulse, differential arterial pressure and the need of surgery. Of the first group only one of the patients, who is now 2 years old, is in good clinical condition; the others needed to be surgically intervened. Of the second group 4 patients, all of whom were over 3 months old at the time of the angioplastic had positive results. The rest needed surgical intervention.

[Congenital brain arteriovenous shunt. cardiological aspects (author's transl)]. / Fístula arteriovenosa cerebral.

An infant with a congenital brain arteriovenous shunt and secondary aneurism of Galen vein is related. Abnormal electrocardiogram without physical signs of primary cardiopathy is observed. Complete description of the case is done and the problems originated from a cardiological point of view are discussed.