Cardiac tumors in newborns

Cardiac tumors in newborns . Congenital blood cysts. Small red nodules found in the valves of the heart . They are usually multiple and rarely larger than 1mm, which disappear after a few weeks or months of life.

Summary

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  • 1 Classification
  • 2 Clinical picture
  • 3 Radiological Exam
  • 4 Pathological anatomy
  • 5 Diagnosis
  • 6 Sudden death
  • 7 Bibliographic references
  • 8 Source

Classification

  • Focal myxomas . Silent at birth and made of myxedema tissue .
  • Lambé excrescences . Small hairy projections on the free edge of the valves. It consists of a fibrous and elastic tissue covered by endocardium .
  • Rhabdomyomas They have been described between 6 and 45 years of age. 50% of cases are associated with tuberous sclerosis. It is seen as a nodular protrusion through the epicardium; Its size ranges from 0.3 to 1 cm in diameter, located in the myocardium. Histologically formed by muscle fibers and protoplasmic stroma and nucleus towards the periphery of the cell.
  • Intramural fibromas It is a tumor of the myocardium of the left ventricle and the ventricular septum . Microscopically it has collagen bands , fibroblasts, and muscle fibers between them.
  • Myxomas It is one of the most frequent and is reported from fetal life to 60 years of age. 75% is located in the left atrium and 25 in the right. More rarely they are located in the ventricles or both atria. The friable mixedematoso tumor can pulmonary thromboembolism or peripheral.
  • Sarcomas They have been described from 3 to 80 years of age. They metastasize early to the lung , liver, and lymph nodes .
  • Pericardial tumors They constitute 20% of cardiac tumors and include teratomas , fibroids , lipomas , angiomas, and leiomyofibromas .

Clinical picture

Symptoms appear early in the first days or months of birth and without surgical treatment die before six months of age.

The original clinical finding is a beat at the top of the epigastrium . The study with catheterization , angiogram and echocardiogram define the diverticulum and its size. The clinical picture depends on the location of the tumor in the heart, which can be in the pericardium , intramural or intracavitary. Intramural tumors grow very slowly and appear on the radiological view of the chest as projected masses of the left ventricle and calcification of the tumor.

Tumors located in the cavity can cause a significant murmur , neurological signs, and loss of consciousness. Electrocardiographic examination revealed negative T waves, left ventricular growth, or combined. They can manifest cardiac arrhythmias , heart block, ventricular tachycardia, and more rarely heart attack .

The tumors and pericardial cysts cause alterations of cardiac contour on the front view of the radiation ray . Pericardial tumors cause pericardial effusion, particularly in children with teratomas, they are profuse and sometimes bloody. EKG tracing is low-voltage or normal.

In adults, metastatic tumors are more frequent than primary tumors and reach the heart through the blood or lymphatic pathway. The melanoma is the tumor that is more prevalent in affect the heart, such as thyroid carcinoma , liver and kidney .

Radiological Exam

  1. On chest radiography a protrusion from the left ventricle . 2. An electrocardiographic examination that shows a Q wave or ST segment elevation and abnormal T waves. 3. Underlying diseases such as leukemia , tuberous sclerosis or a malignant tumor in another part of the body. 4. Significant murmur that varies with changes in body position. 5. Persistent spill in a child. 6. If a cardiac tumor is suspected, complete the study with an echocardiogram and computed tomography.

Pathological anatomy

It consists of a diverticulum of the left ventricle that projects outward and downward protruding into the epigastrium . It is a sac that continues with the pericardium and affects the diaphragm and the abdominal wall . The pericardial sac is continuous with the left ventricular cavity and its components include the pericardium, endocardium, and heart muscle .

Diagnosis

The diagnosis is suspected immediately that a pulsating mass is palpable in the upper part of the epigastrium . Differential diagnosis is made with cordis ectopia that the heart is in the abdominal cavity, whereas in the diverticulum of the ventricle left heart is in the chest . In the front and lateral views of the chest radiograph they define the difference between the two pathologies. The treatment of choice is removal of the diverticulum and repair of the diaphragm and abdominal wall.. Brain Complications of Congenital Heart Defects Brain complications of congenital heart defects can be classified into three groups: Hypoxic crisis with or without loss of consciousness, or seizures Hypoxic episodes called blue or apneic crisis are seen in cyanotic congenital heart defects with loss of or without consciousness or convulsion. The fever , anemia , stress, can trigger crises hypoxia and precipitate the phenomenon unknown causes hypoxic .

Sudden death

Sudden death in children of general cause can occur for multiple reasons from prematurity to the aspiration of a vomit , defects of the diaphragm , lungs, heart and the central nervous system have been implicated in sudden death in the neonatal period. Other causes such as suffocation , when newborns sleep with adults in the same bed. Cardiac causes may be due to myocarditis , endocardial fibroelastosis , congenital aortic stenosis , paroxysmal tachycardia , heart block , endocarditis, cerebral thromboembolism, ventricular fibrillation and pulmonary thromboembolism . The use of the digitalis must be carefully administered, since when the patient has [[hypoxia] and low potassium, it can trigger ventricular fibrillation and death. Those who suffer obstructive cardiomyopathy , may suddenly die in youth, when they have an electrocardiogram with left ventricular growth and overload of that cavity. Patients with valvular or subvalvular aortic stenosis can suffer sudden death in approximately 15% of cases. Patients who have pulmonary vascular disease with primary hypertensionor secondary can suffer sudden death. Children who undergo surgery for a ventricular septal defect may progress with left anterior fascicular block and right bundle branch block, and with this tracing they may suddenly die. Physical activity and sports must be guided by the doctor according to the cardiovascular abnormality that the child suffers.

 

 

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