Fetal supraventricular tachycardia with giant cardiac rhabdomyoma: Role of post natal sirolimus in a developing country

Abstract

Primary cardiac tumors in fetuses are rare and mainly represent rhabdomyoma. The tumors can be clinically silent or cause hemodynamically significant obstructions. We present a case of giant neonatal cardiac rhabdomyoma with right inflow obstruction complicated by fetal supraventricular tachycardia. Fetal echocardiography revealed the presence of supraventricular tachycardia with multiple cardiac masses, one of which caused an obstruction of the right inflow of the heart. As the baby developed hemodynamic instability due to the mass effect, oral sirolimus was initiated postnatally. Despite the limitation of evidence on the usage of sirolimus in neonatal population, this case report revealed the benefits of postnatal sirolimus in a decrease in the size of the mass without any adverse medication effects. Sirolimus has demonstrated efficacy in neonatal cardiac rhabdomyoma, however, a large prospective study is needed to demonstrate the efficacy.