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Background: Neonatal cardiac tumors are a rare pathology, with an approximate incidence of 0.017% in autopsies and 0.31% in obstetric echographies. The most common primary cardiac tumor is rhabdomyomas and its clinical manifestations are highly variable. Most patients do not require therapeutic management unless there is hemodynamic compromise, in which one option is surgical management, which implies high mortality. Rhabdomyomas are usually associated with tuberous sclerosis, a disease for which drugs such as everolimus or sirolimus have been used. Clinical case: Newborn male patient with no significant history, in whom a cardiac arrhythmia was detected during the routine physical examination. After the evaluation by Pediatric Cardiology, it was determined that the patient had supraventricular extrasystoles, in addition to multiple intracardiac masses that, due to imaging characteristics, were compatible with rhabdomyomas, so it was determined that the cause of cardiac arrhythmia was the presence of multiple tumors. Due to the condition of the conduction system, everolimus and propranolol were used. After 7 days, control of the arrhythmias was achieved and resolution of the tumors was achieved after 8 weeks. Conclusions: Rhabdomyomas are cardiac tumors associated with tuberous sclerosis, clinical complications can be managed effectively with everolimus as in the case presented. [ABSTRACT FROM AUTHOR]

Background: The presence of acute renal injury has been associated with increased cardiovascular morbidity and mortality (sudden death and arrhythmias). Objective: To know the frequency of heart rhythm disorders documented by Holter in patients in need of intermittent hemodialysis due to acute renal injury. Material and methods: A prospective observational study was conducted including patients with a diagnosis of acute renal injury who received intermittent hemodialysis; demographic, clinical and laboratory data were collected from 28 patients. Monitoring was carried out through Holter before, during and after the hemodialysis session. Nonparametric statistics were used, with a significant value of p < 0.05. Risks were established with logistic regression. Results: There was a significant difference in supraventricular extra systoles (82.1% vs. 57.1%), ventricular extra systoles (26.7% vs. 3.6%), and supraventricular tachycardia (6.7% vs. 3.6%). The rest of the rhythm alterations without significance. Conclusions: Intermittent hemodialysis is a factor associated with the appearance of heart rhythm disorders. The death of patients with acute renal injury and substitution was related to ventricular extra systole detected by transhemodialysis Holter. [ABSTRACT FROM AUTHOR]

Millions of people die every year due to cardiovascular diseases. The objective against these diseases is primary prevention, but secondary prevention is the major goal in those individuals who already suffered an event. The order of the cardiovascular complication is the next one: arrhythmia, heart failure, myocardial infarction or stroke, and death. Approximately between 1 and 2 % of adults present heart failure, but this percentage rises to more than 10 % in adults over 70 years. Therefore, it is necessary to diagnose and to treat this complication. Left ventricular ejection fraction is the most important prognosis factor in these patients, because it decreases in 50 % of them. Almost 50 % of patients with heart failure have a conserved systolic function, but a decreased diastolic function. Treatment must improve the structural and functional heart abnormalities. Echocardiography is a useful tool in these patients due to its exactitude, accessibility, safety, and low cost. It provides information about the characteristics of the cardiac chambers and its volumes, the diameter in the walls, and about the diastolic, systolic and valvular function. Recently, echocardiography evolved to third dimension techniques, which seem to be more exact. In the next years, we will have more evidence about this diagnostic modality. [ABSTRACT FROM AUTHOR]

Atrial fibrillation (AF) is the most common arrhythmia in humans. The treatment can be one of the most difficult. It's true that AF itself it's a no-lethal arrhythmia but is often a cause of symptoms that can lead the patient to worsening in his quality of life thet predispose to serious conditions like thromboembolic events and heart failure. There is a general agreement in the benefit of antithrombotic therapy and the need of control of comorbid conditions, but there is not an ideal treatment for AF and the choice for the best treatment is based on the individual differences of each patient. Physician and patient must be aware of the risks and possible complications as well as the options in antiarrhythmic and antithrombotic drugs available in order to choose the best for each patient. We must get the message across that AF patients show a dynamic curse of the disease so reevaluation of the individual risk and response to therapy should be made. [ABSTRACT FROM AUTHOR]

Background: chest x-ray (Rx) is the standard test to assess correct placement of a central venous catheter (CVC). Our objective was to validate the use of four clinical measures (CMs) to assess the proper placement of the line. Methods: during a period of eight month, at the Intensive Care Unit a prospective study was done. A chest Rx was always obtained to assess the position of the catheter. The CMs were: venous return; waveform of the central venous pressure (CVP); arrhythmias while advancing the guide wire and the difference between planned length in cm to be introduced and the length of the catheter introduced. Results: for each parameter alone the sensitivity and specificity found were: for venous return 97% and 22%, for CVP waveform changes 86% and 40%, for arrhythmias 97% and 60%, for difference between planned and real length introduced into the patient 97% and 50% respectively. According to chest x-ray, 78% of the catheters were located at a central position. Using the four CMs, we obtained 86% sensitivity and 90% specificity of the placement of the CVC. Conclusions: the use of each parameter alone is highly sensitive but poorly specific. [ABSTRACT FROM AUTHOR]