Objective:Cardiac myxoma in pregnancy is rare and the clinical characteristics of this entity have been insufficiently elucidated. This article aims to describe the treatment options and the risk factors responsible for the maternal and feto-neonatal prognoses.Methods:A comprehensive search of the literature of cardiac myxoma in pregnancy was conducted and 44 articles with 51 patients were included in the present review.Results:Transthoracic echocardiography was the most common diagnostic tool for the diagnosis of cardiac myxoma during pregnancy. Cardiac myxoma resection was performed in 95.9% (47/49); while no surgical resection was performed in 4.1% (2/49) patients (P=0.000). More patients had an isolated cardiac myxoma resection in comparison to those with a concurrent or staged additional cardiac operation [87.2% (41/47) vs. 12.8% (6/47), P=0.000]. A voluntary termination of the pregnancy was done in 7 (13.7%) cases. In the remaining 31 (60.8%) pregnant patients, cesarean section was the most common delivery mode representing 61.3% and vaginal delivery was more common accounting for 19.4%. Cardiac surgery was performed in the first, second and third trimester in 5 (13.9%), 14 (38.9%) and 17 (47.2%) patients, respectively. No patients died. In the delivery group, 20 (76.9%) neonates were event-free survivals, 4 (15.4%) were complicated and 2 (7.7%) died. Neonatal prognoses did not differ between the delivery modes, treatment options, timing of cardiac surgery and sequence of cardiac myxoma resection in relation to delivery.Conclusion:The diagnosis of cardiac myxoma in pregnancy is important. Surgical treatment of cardiac myxoma in the pregnant patients has brought about favorable maternal and feto-neonatal outcomes in the delivery group, which might be attributable to the shorter operation duration and non-emergency nature of the surgical intervention. Proper timing of cardiac surgery and improved cardiopulmonary bypass conditions may result in even better maternal and feto-neonatal survivals.

Cardiac myxoma in pregnancy: a comprehensive review.

Objective: Cardiac myxoma in pregnancy is rare and the clinical characteristics of this entity have been insufficiently elucidat ed. This article aims to describe the treatment options and the risk factors responsible for the maternal and feto-neonatal prognoses. Methods: A comprehensive search of the literature of cardiac myxoma in pregnancy was conducted and 44 articles with 51 patients were included in the present review. Results: Transthoracic echocardiography was the most common diagnostic tool for the diagnosis of cardiac myxoma during pregnancy. Cardiac myxoma resection was performed in 95.9% (47/49); while no surgical resection was performed in 4.1% (2/49) patients (P=0.000). More patients had an isolated cardiac myxoma resection in comparison to those with a concurrent or staged additional cardiac operation [87.2% (41/47) vs. 12.8% (6/47), P=0.000]. A voluntary termination of the pregnancy was done in 7 (13.7%) cases. In the remaining 31 (60.8%) pregnant patients, cesarean section was the most common delivery mode representing 61.3% and vaginal delivery was more common accounting for 19.4%. Cardiac surgery was performed in the first, second and third trimester in 5 (13.9%), 14 (38.9%) and 17 (47.2%) patients, respectively. No patients died. In the delivery group, 20 (76.9%) neonates were event-free survivals, 4 (15.4%) were complicated and 2 (7.7%) died. Neonatal prognoses did not differ between the delivery modes, treatment options, timing of cardiac surgery and sequence of cardiac myxoma resection in relation to delivery. Conclusion: The diagnosis of cardiac myxoma in pregnancy is important. Surgical treatment of cardiac myxoma in the pregnant patients has brought about favorable maternal and feto-neonatal outcomes in the delivery group, which might be attributable to the shorter operation duration and non-emergency nature of the surgical intervention. Proper timing of cardiac surgery and improved cardiopulmonary bypass conditions may result in even better maternal and feto-neonatal survivals.

reviewcardíaco na gravidez: revisão abrangente

Myxomas are rare tumours but are the most common benign tumours of the heart. They can arise from any heart chamber. However, they arise more frequently from the left atrium. They have rarely been described as originating in early age. A case of left atrial myxoma successfully removed using cardiopulmonary bypass in a 8-year-old child is presented. Review of the literature emphasizes the rarity a nd clinically aggressive behavior of this tumor in this age group. The object of this case report is to present myxoma in children and to evaluate possible differences between young and adult patients. Keywords : Myxoma; Left Atrium DOI: http://dx.doi.org/10.3329/cardio.v4i1.9399 Cardiovasc. J. 2011; 4(1): 99-101

http://imsear.hellis.org/bitstream/123456789/168202/1/cd2012v4n2p171.pdf

Left Atrial Myxoma in a Child: An Uncommon Presentation of a Rare Tumour in Early Age

Background: Osteoporosis behaves as a silent killer. Therefore, a high percentage of the affected people are not aware they have this chronic condition. In this way, the burden of osteoporosis is the burden of its clinical outcome: osteoporotic fractures, which are generally characterized by low-trauma fractures resulting from low bone mineral density (BMD). Objectives: The present study aimed to assess BMD distribution among urban and rural subjects and its relationship with key foods.Material & Methods:In this study, a total of 140 subjects were studied from the study BMD lab of the study hospital. Data were analyzed using Mean, SD, % and correlation by SPSS 24.Results:Mean±SD value of age (yr), BMI, WHR, Lumber-T score, Lumber-BMD, Right Femur -T score, Right Femur-BMD, Left Femur-T score, Left Femur-BMD, Supplementation of the study participants were 54±19, 25±5, 1.0±0.25, -1.0±1.0, 1.0±0.2, -1±1, 1±0.2, -1±1, 1±0.15.Age (yrs), BMI, waist (cm), hip (cm), WHR, Lumber T-score, Lumber Z-score, Lumber BMD (g/cm²), Rt. Fem Neck T-score,Rt. Fem Neck Z-score, Rt. Fem Neck BMD (g/cm²), Lt. Fem Neck T-score,Lt. Fem Neck Z-score, Lt. Fem Neck BMD (g/cm²) of the urban study participants were 51±13, 30±5, 88±16, 95±20, 1±20, -1.6±1.6, -1±1.6, 0.9±0.2, -0.9±1.3, -0.2±1.9, 0.9±0.2, -1±1.2, -0.3±1, 0.8±0.1 respectively and for rural participants the values were 54±14, 25±2.5, 86±9, 92±10, 1±0.2, -2.4±1.5, 0.8±0.2, -1.5±1.3, -0.6±1, 0.7±0.2, -1.6±1.2, -0.7±1 and 0.8±2 respectively. About 48.18% rural subjects had osteoporosis, 34.54% had osteopenia and 17.27% had normal bone health. Again, 28.57% of the urban subjects had osteoporosis, 41.40% had osteopenia and 30% had normal bone density. Fish, egg and meat were associated with BMD. Fish intake had a positive association with lumber T score (r=0.194, p=0.009), LumZ (r=0.016, p=0.031), Lumber BMD (r=0.183, p=0.014). Milk intake has positive association with Lumber t and Lumber BMD (p=0.027, 0.049). Similarly, egg intake has positive association with Lumber BMD, Rt BMD, Lt BMD (p= 0.035, 0.01, 0.019).Conclusions:Nearly 48.18% rural subjects have osteoporosis, 34.54% have osteopenia and 17.27% have normal bone health. Again, 28.57% urban subjects have osteoporosis, 41.40% have osteopenia and 30% have normal bone density. The prevalence of osteoporosis is higher in rural area than urban peopleand osteopenia is higher in urban area than rural area. Fish, milk and egg consumption positivelyassociated with BMD.

Bone Mineral Density in an Urban Hospital in Dhaka City of Bangladesh

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Left Atrial Myxoma in a Child: An Uncommon Presentation of a Rare Tumour in Early Age

Bone Mineral Density in an Urban Hospital in Dhaka City of Bangladesh