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Med Bull Sisli Etfal Hosp. 2017; 51(4): 329-333 | DOI: 10.5350/SEMB.20160710113812 | |||
Yenidoğan mortalitesinin nadir bir nedeni: Uzun QT sendromuDuygu Besnili Acar1, Sinan Uslu1, Taliha Öner2, Umut Zübarioğlu1, Ali Bülbül1, Evrim Kıray Baş1, Ebru Türkoğlu Ünal11Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, Yenidoğan Kliniği, İstanbul - Türkiye2Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Çocuk Kardiyoloji Kliniği, İstanbul - Türkiye Amaç: Uzun QT sendromu yenidoğan döneminde nadir görülen mortalitesi yüksek bir sendromdur. Olgumuz yenidoğan polikliniğine morarma ve emmede azalma şikayeti ile getirilen, uzun QT’ye bağlı venriküler taşikardisi gelişen ve tedaviye yanıt alınamayan hastada gerçekleştirilen tanısal ve tedavisel yaklaşımların güncel literatür eşliğinde tartışılması amacıyla sunuldu. A rare cause of neonatal death: Long QT syndromeDuygu Besnili Acar1, Sinan Uslu1, Taliha Öner2, Umut Zübarioğlu1, Ali Bülbül1, Evrim Kıray Baş1, Ebru Türkoğlu Ünal11Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, Yenidoğan Kliniği, İstanbul - Türkiye2Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Çocuk Kardiyoloji Kliniği, İstanbul - Türkiye Objective: Long QT syndrome is a rare syndrome with a high mortality rate in neonatal period. We report a newborn who was admitted to the outpatient clinic with complaints of cyanosis and breastfeeding difficulties, diagnosed as ventricular tachycardia due to long QT syndrome with no response to the treatment, and evaluate the diagnostic and therapeutic approaches in the context of current literature. Case: A newborn delivered at 41th week of pregnancy by cesarean delivery with a birth weight of 3460 grams was admitted to the emeregency outpatient clinic at postnatal seventh day with complaints of breastfeeding difficulty and cyanosis. Newborn was in a poor general condition with impaired peripherical circulation, with respiratory rate 80/min, heart rate 280/min, and oxygen saturation 60%. The newborn was intubated and admitted to the neonatal intensive care unit (NICU). Electrical cardioversion at 1 joule/kg was performed due to ventricular tachycardia (VT) detected at electrocardiography (ECG). After restoration of sinus rhythm, corrected QT (QTc) interval was measured as 0.53 sec. Echocardiography was performed and no structural cardiac anomaly was detected but severe mitral and tricuspid valve regurgitations were present and the ejection fraction (EF) was 30%. Because of recurrence of ventricular tachycardia (VT), synchronized cardioversion at 1 joule/ kg and 2 joule/kg were performed, followed by lidocaine therapy when no response was obtained. Due to the resistant VT, amiodarone, flecainide and esmolol were administered subsequently. Patient failed to respond to any antiarrhythmic treatment and was lost on day 3 of follow-up, after emerging ventricular fibrillation. Duygu Besnili Acar, Sinan Uslu, Taliha Öner, Umut Zübarioğlu, Ali Bülbül, Evrim Kıray Baş, Ebru Türkoğlu Ünal. A rare cause of neonatal death: Long QT syndrome. Med Bull Sisli Etfal Hosp. 2017; 51(4): 329-333 Sorumlu Yazar: Duygu Besnili Acar, Türkiye |
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