[Dilated cardiomyopathy in childhood: clinical aspects, echocardiographic diagnosis]. / Cardiomiopatia dilatativa nell'infanzia: clinica, diagnosi ecocardiografica.

The authors report a study of 30 patients admitted to hospital between January 1982 and August 1994 for dilatative cardiomyopathy. The majority of children were under one year old. At the time of admittance all patients were suffering from congestive heart decompensation. A clinical examination, electrocardiogram and chest X-ray led to a suspected diagnosis of dilatative cardiomyopathy, and mono, 2-dimensional and Doppler echocardiography constantly showed left atrial and ventricular failure, widespread parietal hypokinesia and associated mitralic insufficiency, all of which represent the essential data for a full and reliable diagnosis of this disease. Echocardiography also allowed the evolution of the pathology to be followed non-invasively without risk for such small patients. The authors underline the value of clinical data and in particular echocardiographic findings in the diagnosis and management of dilatative cardiomyopathy.

[Complete transposition of great vessels: clinical aspects, diagnosis, echocardiography]. / Trasposizione completa dei grossi vasi: clinica, diagnosi ecocardiografica.

The paper reports the study of 12 patients admitted to hospital between January 1992 and October 1994. The patients were almost all neonates. Clinical, electrocardiographic and radiological data led to the suspected diagnosis of complete transposition of the great vessels. 2-D echocardiography consistently showed the parallel disposition of great vessels, the anterior position of the aorta compared to the pulmonary artery, the origin of the pulmonary artery from the left ventricle and the aorta from the right ventricle, all of which are the anatomopathological characteristics of this congenital cardiopathy, together with associated malformations, thus enabling a certain diagnosis to be made. The authors underline the value of echocardiography in the diagnosis of complete transposition of the great vessels.

[The echocardiographic diagnosis and pre- and postoperative assessment of total anomalous pulmonary venous return in the coronary sinus in a nursing infant]. / Diagnosi ecocardiografica e valutazione pre- e postoperatoria del ritorno venoso polmonare anomalo totale in seno coronarico nel lattante.

The author reports a case of total anomalous pulmonary venous drainage in a coronary sinus diagnosed using mono- and bidimensional ECG. ECG showed right ventricular strain, the reduced dimension of the left cavities, an echo-free space behind the left atrium referable to the venous collector tubule and a dilated coronary sinus. When ECG data were evaluated in the clinical context total anomalous pulmonary venous drainage in a coronary sinus was diagnosed and subsequently confirmed by intraoperative findings. The author underlines the value of ECG examination and in particular bi-dimensional ECG in the non-invasive diagnosis and pre- and postoperative evaluation of total anomalous pulmonary venous drainage in a coronary sinus in a neonate.

[The echocardiographic diagnosis and evolution of coronary aneurysms in Kawasaki's disease]. / Diagnosi ecocardiografica ed evoluzione degli aneurismi coronarici nella malattia di Kawasaki.

Some cases of coronary aneurysms studied echocardiographically in children suffering from Kawasaki's disease are reported. In the fourth case, bidimensional echocardiography highlighted a uniform dilatation of the right and left coronary proximal segments which had retreated at subsequent controls. In the third case, echocardiogram clearly showed large aneurysms in the common trunk of the left coronary artery, in the left circumflex artery and in the anterior interventricular artery. In other cases, the echocardiogram pointed to the presence of proximal and distal coronary aneurysms whose course it was possible to follow. Stress is laid on the usefulness of dimensional echocardiographic examination in the non-invasive diagnosis of coronary aneurysms in Kawasaki's disease.

[Kawasaki disease: clinical aspects, diagnosis and cardiovascular complications]. / Malattia di Kawasaki: clinica, diagnosi e complicazioni cardiovascolari.

The author makes a series of personal comments regarding the clinical and instrumental documentation of Kawasaki's disease and its cardiovascular complications. The case in question presented all the characteristic symptoms and cardiovascular complications of Kawasaki's disease and it was possible to diagnose and follow their evolution with the aid of ECG, telecardiogram and echocardiogram. The author underlines the value of clinical symptoms and instrumental data in the diagnosis of Kawasaki's disease.

[Persistence of the right venous sinus valve simulating a right atrial myxoma in a case of total anomalous pulmonary venous return. Echocardiographic, anatomo-clinical and surgical aspects]. / Persistenza della valvola del seno venoso destro simulante un mixoma atriale destro in un caso di ritorno venoso polmonare anomalo totale. Aspetti ecocardiografici, anatomoclinici e chirurgici.

A case of persistence of the right venous sinus valve that on echocardiographic examination simulated right atrial myxoma is reported in a patient with total abnormal pulmonary venous return in the coronary sinus. Echocardiography showed a mobile, pedunculated mass present in systole in the right atrium that shifted to diastole in the right ventricle, highly suggestive of right atrial myxoma. The right ventricle also showed a volume overload and a space without echoes behind the left atrium. A membrane was encountered in the right atrium at surgery. This was removed and the venous return corrected.

[Pindolol in pediatrics. Evaluation of cardiac haemodinamics (author's transl)]. / Il pindololo in pediatria. Valutazione della dinamica cardiaca.

Pharmacological clinical studies about beta-blocking agents provide profound insights into the effects of these kinds of drugs in adults. Very little research on children has been done up to now. The hydroalcoholic solution of a beta-blocking agent (Visken Sandoz) facilitated this research on children. This paper investigates the effects of a beta-blocking agent in 19 healthy children aged between 5 and 13 years: arterial blood pressure, heart rate, systolic and diastolic parameters were controlled. The children were examined before and after a 10 day therapeutical cycle in which Pindolol 250 gamma/kg/die was administered. Statistically significant variations were obtained for TD, TT, TT/TET, QTc, but no variation for heart rate, TET, SM, QA2, diastolic parameters and arterial blood pressure. It is supposed that negative chronotropic effect and hypotensive activity were found only in patients with an altered cardiac rate and with an altered arterial blood pressure respectively. The kinetics of the drug is also described and its easy pediatric utilization is underlined.