Thyroid hormones have an important role in the regulation of the cardiovascular system. The aim of this study was to investigate the presence of subclinical myocardial dysfunction in children with euthyroid Hashimoto’s thyroiditis (eHT) without evident heart disease using tissue doppler imaging (TDI) and speckle tracking echocardiography (STE) methods. TDI and STE were peformed in 50 children with eHT and in 35 healthy children. To assess myocardial velocities and time intervals, including peak systolic velocity (Sm), peak early diastolic velocity (Em), peak late diastolic velocity (Am), isovolumetric contraction time (IVCT), isovolumetric relaxation time (IVRT) and ejection time (ET), TDI was performed at the base of the interventricular septum (IVS) and in the left and right ventricles (LV and RV, respectively). Analysis of myocardial deformation by STE including strain (S) and strain rate (SR) was performed globally in two planes, longitudinal (L) and mid-circumferential (C) in LV [LV global longitudinal strain (LVGLS), LV global longitudinal strain rate (LVGLSR), LV global circumferential strain (LVGCS), LV global circumferential strain rate (LVGCSR)] and RV [(RV global longitudinal strain (RVGLS), RV global longitudinal strain rate (RVGLSR)]. Among TDI parameters, ET at LV and IVS were significantly lower, IVRT and myocardial performance index at LV and IVS were significantly higher in the eHT group compared to controls (p=0.001). There were no significant differences in Sm, Em, Am and IVCT values between patients and controls. LVGLS, LVGLSR, LVGCS and LVGCSR values were significantly lower in patients than controls (p=0.01). There was a negative correlation between thyroid antibody levels and LV global longitudinal and circumferential strain and strain rate values (TPO-Ab and Tg-Ab between LVGLS, LVGLSR, LVGCS and LVGCSR; r=-411, p<0.001; r=-541, p<0.001; r=-430, p<.0.001; r=-502, r<0.01 and r=-397, p<0.001; r=-473, p<0.001; r=-519, p<0.001; r=-421, p<0.00, respectively). The results show that myocardial function in children with eHT is impaired in the absence of any clinical symptoms and that conventional echocardiography is inadequate to determine these changes.

Background: This study aims to evaluate the role of speckle-tracking echocardiography to identify myocardial deformation in acute rheumatic fever.Methods: Twenty-seven patients and 27 healthy children were prospectively evaluated. The patient group was divided into 2 subgroups based on echocardiographic findings, with or without carditis. The left ventricular global longitudinal strain and strain rate, left ventricular global circumferential strain and strain rate, and right ventricular global lon- gitudinal strain and strain rate were assessed by speckle-tracking echocardiography.Results: In the acute phase of the disease, all values except the right ventricular global longitudinal strain were found to be significantly below the control group in the patient cohort. No significant difference was found between the patients grouped as carditis and non-carditis in the acute period. Comparison of the acute period with the post -treat- ment period revealed a significant increase in all strain values of the patients with carditis and significant increases observed in all values except left ventricular global longitudinal strain rate, left ventricular global circumferential strain rate, and right ventricular global longitudinal strain rate values in patients without carditis. Apart from the right ven- tricular global longitudinal strain rate, which was significantly lower in the non-carditis group compared to the control group, there was no significant difference in strain values between the patient and control groups following treatment.Conclusion: In the present study, we found that all patients, including patients in whom no valvular involvement was detected by echocardiography in the acute phase of acute rheumatic fever, had a lower right and left ventricular strain and strain rate measure- ments and that these findings improved after treatment, suggesting that strain echo- cardiography may be a helpful diagnostic method, especially in patients without valvular involvement.

While transcatheter atrial septal defect closure is routinely performed, acute biventricular failure is an extraordinary complication in adolescents, with only anecdotal reports in the literature. We present a 16-year-old male with borderline left ventricular systolic function and biventricular diastolic dysfunction who developed transient severe biventricular failure immediately following Amplatzer Septal Occluder (Abbott, Plymouth, MN, USA) deployment. Preprocedural echocardiography revealed right ventricular dilation, a D-shaped septum in diastole. Intraprocedural haemodynamic assessment demonstrated elevated right ventricular diastolic pressures (right ventricular minimal diastolic pressure: 11 mmHg; end-diastolic pressure: 17 mmHg). Haemodynamic collapse occurred within minutes of device release, necessitating emergent dopamine infusion and urgent coronary angiography to rule out device-related complications. Remarkably, ventricular function normalised within 2 hours, enabling extubation the same day. Reports of transient biventricular failure following atrial septal defect closure in adolescents without comorbidities are exceedingly rare, underscoring the critical role of preexisting diastolic dysfunction in precipitating acute decompensation. This case advocates for preprocedural balloon occlusion testing and vigilant haemodynamic monitoring in adolescents with impaired ventricular compliance to mitigate catastrophic outcomes.

Göğüs ağrısı, çocukluk çağında acil servis, pediatri ve çocuk kardiyoloji kliniklerine en sık başvuru nedenlerinden biridir. Ağrı genellikle ciddi bir nedenden kaynaklanmasa da, hasta ve ebeveynleri için endişe kaynağı olabilir. Klinisyenler, altta yatan önemli bir neden olduğunu düşünmedikçe, aileyi göğüs ağrısının iyi huylu doğası hakkında bilgilendirmelidir. Aile ve hasta kaygısını arttırdığı ve gereksiz değerlendirmelere neden olabileceği için bu hastaların rutin olarak kardiyoloji bölümüne sevk edilmesi önerilmemektedir. Göğüs ağrısı her yaşta ortaya çıkabilir, ancak 10 yaşından sonra görülme sıklığı artar. En sık nedenler kostokondrit, travma veya kas gerilmesine bağlı göğüs duvarı kas ağrısı ve solunum yolu hastalıklarıdır. Kardiyak nedenlerin prevalansı %6'dan daha azdır ve daha ileri tanısal çalışmalar her zaman gerekli değildir.

Spontaneous rupture of a giant coronary artery aneurysm is a rare and almost uniformly fatal complication of Kawasaki disease. We report an 18-month-old boy with incomplete, immunoglobulin-resistant disease whose giant aneurysms ruptured despite pulse corticosteroids, anakinra, bedside sternotomy, and extracorporeal support. Six comparable paediatric cases are reviewed, underscoring that aggressive therapy may not prevent rupture once structural arterial wall destruction has occurred.