Kwiatkowska Joanna, Wałdoch Anna, Meyer-Szary Jarosław, Potaż Piotr, Grzybiak Marek
Department of Pediatric Cardiology and Congenital Heart Defects, Medical University of Gdańsk, Poland.
Department of Clinical Anatomy, Medical University of Gdańsk, Poland.
Adv Clin Exp Med. 2017 Mar-Apr;26(2):319-326. doi: 10.17219/acem/62121.
The use of new imaging techniques has contributed significantly to earlier diagnosis and treatment of cardiac tumors.
The aim of the study was to analyze data from children with cardiac tumors in terms of clinical presentation, the role of noninvasive diagnostic procedures and the long-term outcome.
The data analyzed retrospectively concerned 30 children in whom cardiac tumors were diagnosed from January 1995 to July 2015. The cardiac evaluation included a review of the subjects' medical records and medical history, a physical examination, standard 12-lead electrocardiography, echocardiography and 24-h Holter ECG monitoring at the time of diagnosis and at 6-12 month intervals during the follow-up at the authors' outpatient clinic.
Most of the children did not need cardiac surgery; surgical tumor excision was necessary in 3 cases only. There was 1 death in the follow-up period. Rhabdomyoma was diagnosed in 22 cases, and in 16 of them tuberous sclerosis was confirmed during the follow-up period. In the remaining 8 cases, fibroma was the most likely diagnosis.
The symptomatology of cardiac tumors in children can vary greatly, from the absence of any symptoms up to heart failure and respiratory distress indicating the need for surgical intervention. The diagnosis of cardiac tumors relies almost exclusively on noninvasive imaging techniques. The observations in this study confirm the fact that the most common cardiac tumor in children is rhabdomyoma, which may disappear spontaneously. Most patients with cardiac tumors do not require treatment.
新型成像技术的应用对心脏肿瘤的早期诊断和治疗起到了显著作用。
本研究旨在分析儿童心脏肿瘤患者的临床表现、非侵入性诊断程序的作用及长期预后的数据。
回顾性分析1995年1月至2015年7月间诊断为心脏肿瘤的30例儿童患者的数据。心脏评估包括查阅患者病历和病史、体格检查、标准12导联心电图、超声心动图以及在诊断时和作者门诊随访期间每隔6 - 12个月进行的24小时动态心电图监测。
大多数儿童无需心脏手术；仅3例需要进行肿瘤手术切除。随访期间有1例死亡。诊断为横纹肌瘤的有22例，其中16例在随访期间确诊为结节性硬化症。其余8例最可能的诊断为纤维瘤。
儿童心脏肿瘤的症状表现差异很大，从无症状到出现心力衰竭和呼吸窘迫等需要手术干预的症状。心脏肿瘤的诊断几乎完全依赖于非侵入性成像技术。本研究的观察结果证实了儿童最常见的心脏肿瘤是横纹肌瘤，其可能会自发消失。大多数心脏肿瘤患者无需治疗。
