Augmented ventricular rate following verapamil treatment for atrial fibrillation with Wolff-Parkinson-White syndrome.
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Biomedical subjects
Publications and source records attributed to T W Rowland.
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Despite the well-recognized advantages of breast-feeding to both mother and child, malnutrition of breast-fed infants can occur. We report two cases of breast-fed infants with cachexia, hypernatremia, and, in the one case in which it was measured, an elevated level of breast-milk sodium. These cases, along with several reported previously, emphasize the need for proper education and close and early follow-up of the nursing mother and infant, especially since a lack of parental awareness can be part of this syndrome.
The partial absence of the left pericardium is an unusual cause of syncope and chest pain in children. The identification of this lesion is important because of potential herniation of the left side of the heart through the defect, resulting in fatal strangulation. Initial suspicion of the diagnosis should be raised by the typical cardiac contour on the chest roentgenogram. Two-dimensional echocardiography and cineangiography at cardiac catheterization are additional helpful studies in identifying partial pericardial defects.
A 7-month-old girl succumbed to respiratory failure following exposure to high-density mercury vapor produced by heating of the metal in the home. Her course typified inhalation mercury toxic reaction, which in its focus on pulmonary damage creates a clinical picture distinct from that of chronic and oral mercury poisoning.
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Technologic advances in the diagnosis and treatment of children with congenital heart disease have created new, expanded roles for the practicing pediatrician. Early identification of infants with serious lesions continues to be vital, and support of children and their families following surgery is central to the solution of emotional, employment, and childbearing problems these patients may eventually face.
Three breast-fed infants of primiparous women had hypothermia, azotemia, and severe dehydration and malnutrition. No disease entities were identified. Although the cause of inadequate breast nutrition was unclear, these cases underscore the necessity for close follow-up and support of first-born breast-feeding babies.
The experience of three institutions in the management of atrial flutter in infants under 2 years of age without associated heart disease is reviewed. Five babies with neonatal onset were treated with digoxin and had uncomplicated resolution of their arrhythmia, although one continued to have episodes of paroxysmal supraventricular tachycardia for six years. Two of the three older infants required DC cardioversion for complications after quinidine was substituted for digoxin therapy. Digoxin continues to be the preferred initial therapy for non-acutely ill patients; those showing signs of cardiac decompensation should be converted with DC countershock.
Aortic valve regurgitation and saccular aneurysm of the ascending aorta developed in a 5-year-old boy following severe compressive injury to the chest. While rare, traumatic aortic valve disruption may lead to serious cardiac dysfunction. Recognition of acute arotic insufficiency and other forms of cardiac damage requires special attention in patients with nonpenetrating chest injury.
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