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Aniela Luminita Rugina

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

Pulmonary atresia – unfavorable prognostic factor in tetralogy of Fallot with neonatal onset

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 1, An 2012
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Pulmonary atresia – unfavorable prognostic factor in tetralogy of Fallot with neonatal onset

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ABSTRACT

Infundibular or valvular pulmonary atresia occurs in 15-25% of tetralogy of Fallot cases, is manifested clinically in the neonatal period, is included in the ductdepedent congenital heart disease (CHD), requires prostaglandin E1 infusion and early surgical treatement. Tetralogy of Fallot may associate more anatomical variants, some with poor prognosis in the first year of life, if the cardiovascular surgery is not performed in time, most commonly in the neonatal period. The aim of this article is presenting a clinical case of tetralogy of Fallot and pulmonary atresia, diagnosed in the neonatal period, with severe cyanosis and had a progression to death whithin 6 months of life. Pathologic examination revealed malformative association: renal left hypoplasia, with left megaureter and hidrocalicosis without urinary tract infection.

Key words: infant, cyanosis, tetralogy of Fallot, pulmonary artery atresia, pathological examination

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ATREZIA PULMONARA – FACTOR DE PROGNOSTIC NEFAVORABIL IN TETRALOGIA FALLOT CU DEBUT NEONATAL

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 1, An 2012
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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ATREZIA PULMONARA – FACTOR DE PROGNOSTIC NEFAVORABIL IN TETRALOGIA FALLOT CU DEBUT NEONATAL

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REZUMAT

Atrezia infundibulară sau valvulară pulmonară apare la 15-25% dintre cazurile de tetralogie Fallot, se manifestă clinic din perioada neonatală, fiind inclusă în cardiopatiile congenitale critice ductodependente, impunând perfuzie endovenoasă cu prostaglandine E1 şi tratament chirurgical precoce. Tetralogia Fallot poate asocia mai multe variante anatomice, unele cu prognostic nefavorabil în primul an de viaţă, în cazul în care intervenţia chirurgicală cardiovasculară nu este efectuată în timp util, cel mai frecvent în perioada neonatală. Este prezentat un caz clinic de tetralogie Fallot şi atrezie de valvă pulmonară (VP), diagnosticat în perioada neonatală, când a prezentat cianoză severă şi care a avut o evoluţie spre deces în primele 6 luni de viaţă. Examenul anatomopatologic a evidenţiat asocieri malformative: hipoplazie renală stângă, cu megaureter şi hidrocalicoză stângă, fără infecţie de tract urinar.

Cuvinte cheie: sugar, cianoză, tetralogie Fallot, atrezie de arteră pulmonară, examen anatomopatologic.

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Bland-White-Garland syndrome with early fatal evolution

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 3, An 2012
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Bland-White-Garland syndrome with early fatal evolution

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ABSTRACT

The authors present the case of an 2 months old infant, who is hospitalized for clinical signs of congestive heart failure, with dilated cardiomyopathy on Doppler echocardiography and myocardial infarction on ECG. Despite the medical treatment the evolution was unfavorable, and pathological examination confirms the anomalous origin of the left coronary artery (LCA) from the pulmonary artery (PA), dilated left ventricular cardiomyopathy, secondary subendocardic fibroelastosis and necrosis.

Key words: anomalous origin of the left coronary artery, heart failure, dilated cardiomyopathy, myiocardial ischemia

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SINDROM BLAND-WHITE-GARLAND CU EVOLUTIE FATALA PRECOCE

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 3, An 2012
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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SINDROM BLAND-WHITE-GARLAND CU EVOLUTIE FATALA PRECOCE

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REZUMAT

Autorii prezintă cazul unui sugar în vârstă se 2 luni, care se internează pentru semne clinice de insuficienţă cardiacă congestivă ce asociază hipotensiune arterială şi timp de recolorare prelungit, cu cardiomiopatie dilatativă la ecocardiografia Doppler şi modificări ischemice pe EKG. În ciuda tratamentului medicamentos, evoluţia a fost nefavorabilă, iar examenul anatomopatologic confirmă originea anormală a arterei coronare stângi (ACS) din artera pulmonară (AP), cardiomiopatia dilatativă a ventriculului stâng şi evidenţiază fibroelastoză şi necroză subendocardică secundare.

Cuvinte cheie: origine anormală a arterei coronare stângi, insuficienţă cardiacă, cardiomiopatie dilatativă, ischemie miocardică

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ACCIDENT VASCULAR CEREBRAL ISCHEMIC LA UN COPIL CU CARDIOPATIE CONGENITALA CIANOGENA COMPLEXA

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Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 3, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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ACCIDENT VASCULAR CEREBRAL ISCHEMIC LA UN COPIL CU CARDIOPATIE CONGENITALA CIANOGENA COMPLEXA

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REZUMAT

Accidentul vascular cerebral (AVC) este rar la copil comparativ cu adultul. Cauzele cele mai comune de AVC la copil sunt cardiopatiile emboligene pentru infarctul cerebral şi malformaţiile arteriovenoase pentru hemoragiile cerebrale, dar un număr de cazuri rămân idiopatice, fără a li se putea afi rma etiologia precisă. Autorii prezintă cazul unui copil diagnosticat în perioada de sugar cu malformaţie congenitală de cord cianogenă complexă, dar neoperată, internat cu semne clinice şi radiologice de pneumonie, care a evoluat favorabil sub tratament antibiotic şi simptomatic. În timpul perioadei rezolutive a pneumoniei, copilul devine brusc somnolent, prezentând hemiplegie dreaptă cu absenţa refl exelor de aceeaşi parte. Examenul clinic corelat cu CT cranio-cerebral au stabilit diagnosticul de AVC ischemic sylvian bilateral. Evoluţia a fost favorabilă sub tratament conservator (antiagregante plachetare, fi zioterapie), persistând însă hemiplegia dreaptă.

Cuvinte cheie: accident vascular ischemic, malformaţie congenitală cardiacă, copil, hemiplegie

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ISCHEMIC STROKE IN A CHILD WITH COMPLEX CYANOTIC CONGENITAL HEART DISEASE

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Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 3, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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ISCHEMIC STROKE IN A CHILD WITH COMPLEX CYANOTIC CONGENITAL HEART DISEASE

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ABSTRACT

Stroke is rare in children compared to adults. Most common causes of stroke in children are heart diseases that cause embolism and cerebral infarction and arteriovenous malformations for the brain hemorrhages, but a number of cases remain idiopathic, without being able to say precise etiology. The authors present the case of a child diagnosed in infancy with complex cyanotic heart malformation, but not operated, admitted with clinical and radiological signs of pneumonia, which evolved favorably with antibiotic and symptomatic therapy. During resolution of the pneumonia, the child becomes suddenly drowsy, presenting right hemiplegia, with absence of refl exes on the same side. Clinical examination correlated with cranio-cerebral CT have established the diagnosis of bilateral Sylvian ischemic stroke. The evolution was favorable under conservative treatment (antiplatelet drugs, physiotherapy), but right hemiplegia persisted.

Keywords: ischemic stroke, congenital heart disease, child, hemiplegia

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