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Intradialytic Hypotension and Left Ventricular Function Improved After Intravenous Levo Carnitine Therapy in a Pediatric Hemodialysis Patient-Juniper Publishers

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JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Abstract Background: The significant decline of endogenous carnitine levels has been well confirmed in a single hemodialysis session. In children, owing to poor tissue stores, and growing demand, a resurgence in carnitine levels may take much longer time. Intradialytic hypotension secondary to carnitine deficiency is commonly due to depressed cardiac function. During hemodialysis, both oral carnitine and intravenous carnitine has been equally effective in adults by reducing the signs and symptoms. However, in children, intravenous carnitine may be more effective in the management of intradialytic hypotension and improving heart function. Case presentation: We report a 9-year-old girl who is a known case of end-stage renal failure secondary to hypoplastic kidneys. Her dialysis is complicated with left ventricular systolic dysfunction, and tertiary hyperparathyroidism for which she und...
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Undetected pulmonary Artery Aneurysms Secondary to Prolonged Right-sided Endocarditis in a Patient with Corrected Tetralogy of Fallot-Juniper Publishers

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JUNIPER PUBLISHERS-OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Abstract Mycotic pulmonary artery aneurysms are a rare complication of right-sided endocarditis most often associated with congenital heart disease or intravenous drug addiction. We report a case of undetected mycotic pulmonary artery aneurysms secondary to prolonged right-sided endocarditis in a 25-years old patient with corrected tetralogy of Fallot /pulmonary atresia. An attempt to explain the delayed diagnosis of endocarditis with subsequent mycotic aneurysms formation is made and the clinical and imaging findings of this rare complication during a long-term follow up are presented, contributing to our knowledge on the natural history of this disease. Keywords: Mycotic aneurysms; Tetralogy of Fallot /pulmonary atresia; Right heart endocarditis; Kocuria varians Abbreviations: CT: Computed Tomography; TTE: Trans Thoracic Echocardiogram; MRI: Magnetic Resonance Imaging; MRA: Magne...
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