Annals of Pediatric Cardiology最新文献

{"title":"Recurrence to persistence: Inflammatory markers in pediatric rheumatic heart disease.","authors":"Lalan Kumar, Sakshi Sachdeva, Dheeraj Deo Bhatt, Dinesh Kumar, Neera Sharma, Vishal Kumar Vishwakarma, Harlokesh Narayan Yadav, Nimisha Sharma","doi":"10.4103/apc.apc_100_26","DOIUrl":"https://doi.org/10.4103/apc.apc_100_26","url":null,"abstract":"<p><strong>Background: </strong>Studies in adults with chronic rheumatic heart disease (RHD) suggest persistence of elevated inflammatory markers, indicating a potential role of ongoing inflammation in disease chronicity. However, similar data in the pediatric population are lacking.</p><p><strong>Methods: </strong>A cross-sectional observational study was conducted in the Division of Pediatric Cardiology at a tertiary care hospital in North India from August 2022 to February 2024. Forty-three patients with RHD <18 years were enrolled. Comprehensive history taking and clinical examinations were conducted. Blood samples were collected to evaluate C-reactive protein (CRP), neutrophil-to-lymphocyte ratio, interleukin-6 (IL-6), IL-17, and tumor necrosis factor alpha (TNF-α) levels. Inflammatory marker levels were compared with American College of Cardiology (ACC) valvular heart disease (VHD) stage.</p><p><strong>Results: </strong>Mean age of participants was 13.14 ± 3.17 years. Mean duration of disease was 3.23 ± 1.98 years. The CRP was elevated in 37.2% (<i>n</i> = 16) patients. IL-6, IL-17, and TNF-α were elevated in all patients. IL-6 (<i>P</i> = 0.036) and IL-17 (<i>P</i> = 0.008) showed significant association with ACC VHD stage.</p><p><strong>Conclusions: </strong>Pediatric RHD patients exhibit elevated blood inflammatory markers in the absence of acute rheumatic fever. Targeting this chronic inflammation could potentially slow progression of RHD.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"527-533"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe pulmonary valve stenosis associated with advanced atrioventricular conduction disease: A rare case report.","authors":"Arshad Nazir, Roopali Khanna, Shubham Srivastava, Aditya Kapoor","doi":"10.4103/apc.apc_118_26","DOIUrl":"https://doi.org/10.4103/apc.apc_118_26","url":null,"abstract":"<p><p>Congenital pulmonary valve stenosis is a common cause of right ventricular (RV) outflow tract obstruction. Advanced atrioventricular (AV) block in congenital heart disease is usually associated with abnormalities of AV septation or conduction system malposition. An association between isolated pulmonary valve stenosis and advanced AV block has not previously been reported. A 16-year-old male presented with exertional dyspnea and recurrent presyncope. Electrocardiography (ECG) revealed 2:1 AV block. Transthoracic echocardiography demonstrated severe valvular pulmonary stenosis with a peak gradient of 100 mmHg and preserved RV function. Cardiac computed tomography confirmed thickened pulmonary valve cusps with poststenotic pulmonary artery dilatation. The patient underwent successful balloon pulmonary valvotomy with significant reduction in RV systolic pressure. As advanced AV block persisted, a dual-chamber permanent pacemaker was implanted. The patient remained asymptomatic on follow-up. This case describes a rare and previously unreported association of advanced AV congenital heart block with isolated pulmonary valve stenosis. Persistence of heart block following relief of RV outflow obstruction suggests an underlying congenital conduction system abnormality. Awareness of this potential association is important when evaluating symptomatic patients with congenital right-sided obstructive lesions.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"564-567"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare constellation: Interrupted aortic arch type C and confirmed 22q11 deletion (DiGeorge syndrome) managed with Yasui procedure in a neonate.","authors":"Mohammed A Radi, Ghassan A Shaath, Mohammed H A Mohammed, Abdullah A Alghamdi","doi":"10.4103/apc.apc_36_26","DOIUrl":"https://doi.org/10.4103/apc.apc_36_26","url":null,"abstract":"<p><p>Interrupted aortic arch (IAA) type C is a rare and complex congenital heart anomaly. DiGeorge syndrome (22q11.2 deletion) is commonly associated with conotruncal anomalies, notably IAA type B, but its association with IAA type C is exceptional. There is only a limited number of reported cases in the literature. Here, we present a case of a full-term neonate diagnosed with IAA type C and confirmed to have 22q11.2 deletion syndrome. It was managed successfully with a Yasui procedure. Our case highlights the critical importance of genetic screening for early diagnosis and the necessity of a proper multidisciplinary team approach. Prompt surgical intervention in these patients is life-saving.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"571-575"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-presenting left-to-right shunts and operability scoring: Finer nuances.","authors":"Ronak Sheth","doi":"10.4103/apc.apc_176_26","DOIUrl":"https://doi.org/10.4103/apc.apc_176_26","url":null,"abstract":"","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"617-618"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rheumatic Heart disease in the Young: Treatment needs, Hospitalization burden, and Measuring economic impact: The RHYTHM Study.","authors":"Sowmya Kasturi, Srinath Reddy Narahari, Swetha Ponnapalli, C Sindhoori, Raman Krishna Kumar","doi":"10.4103/apc.apc_84_26","DOIUrl":"https://doi.org/10.4103/apc.apc_84_26","url":null,"abstract":"<p><strong>Introduction: </strong>Acute rheumatic fever (ARF) and its sequela, rheumatic heart disease (RHD), continue to be major contributors to morbidity and mortality among acquired pediatric cardiac diseases in underprivileged populations. The resulting health expenditures lead to catastrophic financial strain on affected families.</p><p><strong>Materials and methods: </strong>This study analyzed 48 children admitted with ARF or RHD. Data collection focused on total healthcare costs, out-of-pocket expenditures (OOPE) by families, and associated financial impact.</p><p><strong>Results: </strong>A total of 70 hospital admissions were evaluated. The mean age of patients was 11.3 ± 3.1 years. Forty-six (66%) were admitted for decompensated heart failure (HF) due to first episode of ARF in 19 (27%) and recurrence in 17 (24%). Thirty-one (64%) underwent surgery, with two postoperative deaths (6%). Eighty eight (88%) families belonged to upper lower-middle socioeconomic class. The mean hospital stay was 11.5 ± 5 days. Children lost an average of 230 ± 128 school days.Families had an average size of 5.2 ± 1.2 members, with 2.89 ± 0.96 children. In 24 families (50%), both parents were earning. The average daily household income was ₹625 ± 210. Of the families, 8 (16%) earned <₹500 per day. The funding organization (government/trust) covered an average of ₹285,000 ± 66,300 for surgery and ₹30,000 ± 17,650 for HF. Families incurred OOPE of ₹46,000± ₹34,000 for surgeries and ₹18,000± ₹10,000 for HF admissions. This was financed through loans or support networks. Families lost an average of 150 ± 78 workdays. The estimated financial loss per family was ₹160,000 ± 90,000; 10 times the monthly household income. On average, each follow-up hospital visit cost families ₹5000 ± 1600, about nine times their average daily income.</p><p><strong>Conclusions: </strong>ARF and RHD impose a significant financial burden on affected households over and above the funding support for hospitalization and surgery. The substantial indirect costs due to loss of work and travel expenses need to be included to know the complete economic impact of ARF and RHD on families.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"503-512"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress cardiomyopathy following antibiotic-induced anaphylaxis in a 16-month-old child.","authors":"Mareddy Nikhila Reddy, Ramya Keerthy, Rajesh Babu Gudipati, Ravinder Reddy Lotkal","doi":"10.4103/apc.apc_72_26","DOIUrl":"https://doi.org/10.4103/apc.apc_72_26","url":null,"abstract":"<p><p>Takotsubo cardiomyopathy (TTC) is a reversible stress-induced myocardial syndrome characterized by transient left ventricular (LV) dysfunction in the absence of coronary artery disease. Pediatric cases are rare, especially in infants and toddlers. We report a 16-month-old female child who developed TTC following severe pneumonia complicated by antibiotic-induced anaphylaxis, cardiopulmonary arrest, and catecholamine exposure during resuscitation. Electrocardiography showed T-wave inversions, and echocardiography demonstrated transient mid and apical LV hypokinesia with preserved basal function. Cardiac troponin-I was markedly elevated. Serial echocardiography documented complete recovery of ventricular function. This case emphasizes the need to consider TTC in young children presenting with myocardial dysfunction following anaphylaxis and resuscitation and highlights the importance of early echocardiographic evaluation.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"568-570"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Massive idiopathic pericardial effusion in a pediatric patient responsive to interleukin-1 receptor antagonist: Unveiling an undercover hyperinflammation?\"","authors":"Dilek Borakay","doi":"10.4103/apc.apc_197_26","DOIUrl":"https://doi.org/10.4103/apc.apc_197_26","url":null,"abstract":"","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"619-620"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From stent to stability: Conservative management of post-stenting aortic dissection in coarctation of the aorta.","authors":"Khushmi Amit Shah, Sriram Easwaran, Saurabh Vinayak Limaye, Bharat V Dalvi, Pratap J Nathani, Milind S Phadke","doi":"10.4103/apc.apc_95_26","DOIUrl":"https://doi.org/10.4103/apc.apc_95_26","url":null,"abstract":"<p><p>Coarctation of the aorta (CoA) is characterized by congenital narrowing of the aortic isthmus. Primary treatment modalities include balloon dilatation, stenting, and surgical repair. Here, we present the case of a 37-year-old male with refractory hypertension who underwent successful stenting of a severe postductal CoA, achieving complete resolution of the trans-coarctation gradient. Twenty-four hours later, he developed severe inter-scapular pain, and computed tomography aortography revealed an extensive Stanford type B aortic dissection extending from the distal stent margin to beyond the aortic bifurcation. As there were no signs of end-organ malperfusion, conservative management was pursued with close monitoring and blood pressure control. The dissection stabilized and the patient responded favorably, with sustained stability on the follow-up.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"585-588"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major aortopulmonary collateral arteries: A cause of difficult weaning from extracorporeal membrane oxygenator after arterial switch operation.","authors":"Periyasamy Sathesh Kumar, Palaniraj Suresh, Vimlendra Kumar Choudhary, Shrinivas Vitthal Gadhinglajkar, Baiju S Dharan","doi":"10.4103/apc.apc_119_26","DOIUrl":"https://doi.org/10.4103/apc.apc_119_26","url":null,"abstract":"","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"621-622"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coarctoplasty in a case of ventricular septal defect, patent ductus arteriosus with coarctation of aorta and Eisenmenger's syndrome: Is it safe?","authors":"Navreet Singh, Gautam Singal, Sugam Krishna Singh, Arvind Mishra, Ankush Gupta, Ekambir Singh, Ashish Kumar Shukla, Sunny Pathania, Ashutosh Kumar Singh","doi":"10.4103/apc.apc_20_26","DOIUrl":"https://doi.org/10.4103/apc.apc_20_26","url":null,"abstract":"<p><p>Endovascular Coarctoplasty (CoAP) with stenting is the treatment of choice in Coarctation of Aorta (CoA). Literature on the harms or benefits of CoAP in Eisenmenger's syndrome (ES) is scarce. There is the hypothetical possibility of an increase in right-to-left intracardiac shunting once the coarctation is relieved. We report a 17-year-old male adolescent who presented with secondary hypertension, cyanosis, and lower limb claudication. He was diagnosed as a case of ventricular septal defect (VSD), patent ductus arteriosus (PDA), and CoA with associated ES. He underwent successful balloon CoAP with no clinical or invasive hemodynamic deterioration. At one-year follow-up, there was no clinical or echocardiographic evidence of complications from ES or restenosis. This case highlights that CoA with ES can be safely managed by CoAP with good long-term results. The proposed pathophysiology for the uneventful procedure is an extension of our understanding of the 'shunt dynamics' in cyanotic spells in patients with congenital cyanotic heart diseases.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":"19 5","pages":"589-592"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}