Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-18T22:43:02.006Z Has data issue: false hasContentIssue false

Positional cyanosis in infants: an unusual presentation of right-sided cardiac masses

Published online by Cambridge University Press:  20 January 2005

Aviva Levitas
Affiliation:
Pediatric Cardiology Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Gil Gross
Affiliation:
Division of Cardiology, The Hospital for Sick Children, Toronto, Canada
Nili Zucker
Affiliation:
Pediatric Cardiology Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Eli Zalzstein
Affiliation:
Pediatric Cardiology Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

Abstract

Positional cyanosis is an uncommon finding in young patients. We report three infants who presented with positional cyanosis due to a pedunculated tumour in the right heart. Arterial desaturation was the result of right-to-left shunting at the level of the oval foramen caused by obstruction and/or insufficiency of the tricuspid valve. The obstruction at the level of the tricuspid valve was variable because of the pedunculated nature of the tumours, which gave them considerable mobility. Hence, the degree of right-to-left shunting was dependent on the position of the patient. In all the patients, surgical resection of the tumours resolved the cyanosis.

Type
Original Article
Copyright
© 2004 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Nadas AS, Ellison RC. Cardiac tumors in Infancy. Am J Cardiol 1968; 21: 363366.Google Scholar
Strans R, Merliss R. Primary tumors of the heart. Arch Pathol 1945; 39: 7478.Google Scholar
Elderkin RA, Radford DJ. Primary Cardiac Tumours in a pediatric population. J Paediatr Child Health 2002; 38: 173177.Google Scholar
Ferrieri P, Gewitz MH, Gerber MA, et al. Unique feature of infective endocarditis in childhood. Pediatrics 2002; 109: 931943.Google Scholar
Ryan CA, Sodar CM, Zalzstein E, Human DG. Left ventricular thrombus following repair of truncus arteriosus. Pediatr Cardiol 1990; 11: 5758.Google Scholar
Mesia CI, Forman A, Donofrio MT. Transient neonatal cyanosis: unusual presentation of right-sided cardiac masses. Pediatr Cardiol 2000; 21: 271274.Google Scholar
Guntheroth WG, Fujioka MC, Reichenbach DD. Spontaneous resolution of obstructive valvular tumor in infants. Am Heart J 2002; 143: 868872.Google Scholar
Dein JR, Frist WH, Stinson EB, et al. Primary cardiac neoplasm. Early and late results of surgical treatment in 42 patients. J Thorac Cardiovasc Surg 1987; 93: 502511.Google Scholar
Maria-Garcia J, Fitch CW, Shenefelt RE. Primary right ventricular tumor (fibroma) simulating cyanotic heart disease in a newborn. J Am Coll Cardiol 1984; 3: 868871.Google Scholar
Pearlman SA, Higgins S, Eppes S, Bhat AM, Klein JD. Infected endocarditis in the premature neonate. Clin Pediatr 1998; 37: 741746.Google Scholar
Baltimore RS. Infected endocarditis in children. Pediatr Infec Dis J 1992; 11: 907912.Google Scholar
Li L, Cerilli LA, Wick MR. Inflammatory pseudotumor (myofibroblastic tumor) of the heart. Ann Diagn Pathol 2002; 6: 116121.Google Scholar
Zalzstein E, Zucker N, Levitas A. The role of tissue plasminogen activator in a successful treatment of infected thrombi in children. Cardiol Young 2001; 11: 355356.Google Scholar