Cardiac tumors (CT) in children are very rare lesions, but their diagnosis is crucial for patient management. Echocardiography is the most used cardiovascular imaging modality in clinical practice for the initial diagnosis of CT in pediatric patients. Knowing the echocardiographic characteristics of CTs can enable an increasingly early diagnosis and the identification of its most likely etiology. Primary CTs are the most frequent in children, with benign ones being the most prevalent. Among benign CTs, the most frequent in fetuses and neonates are rhabdomyomas and teratomas, while in older children, they are rhabdomyomas and fibromas. In this article we describe the echocardiographic characteristics of the main CTs in pediatric ages.

Spectral analysis was carried out on the R-Wave Attenuation (RWA) trend and Heart Rate Variability (HRV) series, derived from the polysomnographic Electrocardiogram (ECG) of the subjects with and without Cheyne Stokes Breathing. Nocturnal polysomnography was performed on 16 Normal subjects and 7 subjects with Cheyne Stokes Breathing (CSB) patients. The polysomnographic ECG data was divided into fifteen minute epochs for analysis. These epochs are processed to obtain the RWA. Hilbert Transform based algorithm [4] was used for QRS detection. Power spectrum of RWA and HRV are computed for each clip by using Welch's averaged periodogram method. HRV is sensitive to REM sleep as well and hence not specific to sleep apnea [12]. Hence the parameters derived from HRV alone cannot be used as diagnostic markers. Hence a combined detection scheme which uses parameters derived from RWA and HRV power spectrum is used in the proposed method to increase detection accuracy. This method produced a sensitivity of 84.75% and specificity of 87.03% in the training set and sensitivity of 85.78% and a specificity of 87.19% in the test set.

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Objective To analyze the most frequent referrals for fetal echocardiography, including advanced maternal age and its association with abnormal results. Methods We included all pregnant women referred to perform fetal echocardiography (gestational age 22–32 weeks) in 2 health centers in Rio de Janeiro, from June 2015 to June 2016. Advanced maternal age was considered when age was > 35 years at the time of delivery). Referral reasons and results were recorded, according to the Brazilian Fetal Cardiology Statement. Crude and adjusted prevalence ratios were calculated (Poisson regression). We considered p < 0.05 as significant. Results A total of 1,221 tests were analyzed. Abnormal fetal echocardiography was observed in 14.82% of the cases. The most frequent abnormalities were interventricular septal defect (6.39%), septal hypertrophy (3.35%) and atrioventricular septal defect (1.14%). Routine exams were performed in 559 women, 289 were referred for advanced maternal age and 373 were referred according to the Brazilian Fetal Cardiology Statement criteria. An obstetric ultrasound suggesting fetal cardiac abnormality, maternal diabetes, increased nuchal translucency, and obstetric ultrasound suggesting a noncardiac abnormality were strongly associated with an abnormal fetal echocardiography. Abnormal results were not more frequent in women with advanced maternal age when compared with the rest of the study group. Conclusions It was observed that routine exams and advanced maternal age referrals were very frequent. Those exams were not associated to fetal echocardiography abnormalities. In this scenario, when the obstetric ultrasound suggests a fetal cardiac abnormality, the fetal echocardiography probably is abnormal. Therefore, obstetric ultrasound is a good screening method.