D. De Wolf

Myocardial infarction in a neonate with hereditary antithrombin III deficiency

We report the case of a newborn girl with antithrombin III deficiency type 1. The clinical features of a hypercoagulable condition that lead to this rare diagnosis differed from the reports in the literature, since the primary thromboembolic incident resulted in neonatal myocardial infarction, which is in itself a rare condition during the first days of life.

Embolization of a coronary fistula with a controlled delivery platinum coil in a 2-year-old

SummaryCongenital coronary artery disorders are rare. Elective closure is proposed in view of the morbidity reported later in life. Excellent results have been reported with surgery, and recently catheter occlusions have been successful. We report the case of a 2-year-old girl whose coronary artery fistula was occluded with a special controlled delivery coil system.

Adenosine-tri-phosphate treatment for supraventricular tachycardia in infants.

Adenosine is an endogenous nucleoside acting on coronary perfusion and myocardial conduction. Although the anti-arrhythmic effects of adenosine have been known for decades, interest in the use of adenosine or adenosine-tri-phosphate (ATP) (a precursor of adenosine) in termination of supraventricular tachycardia (SVT) has been renewed. We studied the use of striadyne (ATP and a mixture of other nucleosides including adenosine) in 22 infants younger than 6 months in order to evaluate efficiency and safety of the drug in this particular age group. Striadyne stopped SVT in 17 cases and was diagnostic in another 4 cases. Ten out of 17 successfully converted infants showed one or more reinitiations of SVT, which were easily controlled. The results support the efficiency of ATP for the termination of re-entry types of tachycardia, as well as its diagnostic value and its lack of serious side-effects.There could be a role for adenosine or ATP for safe termination of most cases of SVT in infancy before transferring these infants to a specialised paediatric cardiology department.

ECTOPIC ATRIAL TACHYCARDIA IN A YOUNG ATHLETE

We report the case of a young boy on routine sports medical examination, who presented an incessant atrial tachycardia. At the slightest exercise the ventricular rhythm accelerated to 160 beats.min-1. Exercise capacity was excellent, and a treatment with propafenone suppressed the tachyarrhythmia.

Antenatal diagnosis of urological disorders by ultrasound: A critical review

The suspected diagnosis of urological disorders made on the basis of antenatal ultrasonography was compared with the final outcome in 23 cases. In 18 cases the initial diagnosis could be confirmed, whereas 5 showed no postnatal urological anomalies. Further efforts should be undertaken to improve prenatal diagnosis in order to facilitate treatment as early as possible.