Riad Mohammed S, Abdelfadil Mohamed M, Abdelfattah Mahmoud, Wanees Ahmed El Husseny Mostafa, Ahmed Eslam, Ali Aisha, Hosny Hatem, Abdelfattah Mohamed, Kamel Omnia
Cardiac Electrophysiology Department, Magdi Yacoub Heart Foundation, Aswan Heart Center, Aswan, Egypt; Cardiology Department, Armed Forces College of Medicine, Heliopolis, Egypt.
Cardiac Electrophysiology Department, Magdi Yacoub Heart Foundation, Aswan Heart Center, Aswan, Egypt; Faculty of Medicine, Cardiology Department, Fayoum University, Faiyum, Egypt.
JACC Case Rep. 2025 Sep 17;30(28):104933. doi: 10.1016/j.jaccas.2025.104933.
Cardiac masses are rare in pediatric patients, and multimodality imaging is crucial for diagnosis. These masses can present with different arrhythmias, adding challenges to their management.
We report an unusual presentation of cardiac masses in an infant with aborted sudden cardiac arrest, ST-segment elevation electrocardiography, and recurrent supraventricular tachycardia. The masses were distant from the sinoatrial node, yet we detected severe sinus node dysfunction requiring epicardial pacemaker implantation. Although the imaging suggested malignant features, tissue biopsy confirmed the diagnosis of benign rhabdomyoma. No other manifestations of tuberous sclerosis were detected.
Several cases of this tumor were reported to present with arrhythmias. The management of these cases requires a multidisciplinary approach individualized for each patient.
TAKE-HOME MESSAGES: Infants with cardiac rhabdomyoma can experience severe sinus node dysfunction, irrespective of mass location, requiring pacing. Despite current advances in cardiac imaging, tissue biopsy is still the gold standard for accurate diagnosis.
心脏肿物在儿科患者中较为罕见，多模态成像对于诊断至关重要。这些肿物可伴有不同的心律失常，给其治疗带来挑战。
我们报告了一名婴儿心脏肿物的不寻常表现，该婴儿曾发生心脏骤停未遂、心电图ST段抬高以及复发性室上性心动过速。肿物远离窦房结，但我们检测到严重的窦房结功能障碍，需要植入心外膜起搏器。尽管影像学显示有恶性特征，但组织活检确诊为良性横纹肌瘤。未检测到结节性硬化症的其他表现。
有几例该肿瘤的报道显示伴有心律失常。这些病例的治疗需要针对每个患者采取多学科个体化方法。
患有心脏横纹肌瘤的婴儿可出现严重的窦房结功能障碍，无论肿物位置如何，均需要起搏治疗。尽管目前心脏成像技术有所进步，但组织活检仍是准确诊断的金标准。
