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Published on: October 15, 2014
Cardiac rhabdomyomas and their association with tuberous sclerosis
D W Webb1, R D Thomas, J P Osborne
1Bath Unit for Research into Paediatrics, Royal United Hospital, Combe Park.
Insights
Cardiac rhabdomyomas are rare in children, with a minimum birth incidence of 1/326,000. Most affected children (80%) also have tuberous sclerosis, a genetic disorder.
Area of Science:
- Pediatric Cardiology
- Genetics
- Oncology
Background:
- Cardiac rhabdomyomas are benign tumors of the heart, most commonly diagnosed in infants and children.
- Tuberous sclerosis is a genetic disorder that can cause tumors to grow in various organs, including the heart.
Purpose of the Study:
- To determine the birth incidence of cardiac rhabdomyomas in children.
- To describe the clinical presentation, course, and outcomes of affected children.
- To establish the frequency of cardiac rhabdomyomas in patients with tuberous sclerosis.
Main Methods:
- A retrospective search was conducted using data from the British Cardiac Society's pediatric section.
- Fifteen children with cardiac rhabdomyomas were identified.
- Echocardiography was used to assess the prevalence of cardiac rhabdomyomas in tuberous sclerosis patients.
Main Results:
- The minimum birth incidence of cardiac rhabdomyomas is estimated at 1/326,000.
- Tuberous sclerosis was diagnosed in 80% (12/15) of children with cardiac rhabdomyomas.
- Heart failure was the most common presentation (6/15), with a high mortality rate (5/6).
- In patients with tuberous sclerosis, 60% of those under 18 years had cardiac rhabdomyomas.
Conclusions:
- Cardiac rhabdomyomas are rare but serious conditions in children, strongly associated with tuberous sclerosis.
- Early diagnosis and management are crucial for improving outcomes in affected children.
- Further research is needed to understand the long-term prognosis and optimal treatment strategies.
Abstract:
A search for children presenting with signs or symptoms of cardiac rhabdomyomas was made through members of the paediatric section of the British Cardiac Society in order to establish their birth incidence, presenting features, clinical course, and the frequency of a concurrent diagnosis of tuberous sclerosis. Fifteen children were identified and 12 had tuberous sclerosis (80%). Heart failure was the presentation in six, five of whom died; six presented because of a murmur and three because of arrhythmias. The prevalence of echocardiographic evidence of cardiac rhabdomyomas in a population of patients with tuberous sclerosis was established. Twenty individuals had echocardiography and eight had echodensities consistent with cardiac rhabdomyomas. It is concluded that the minimum birth incidence for children presenting because of the effects of cardiac rhabdomyomas is 1/326,000 and a minimum of 80% have tuberous sclerosis. In a population of patients with tuberous sclerosis a minimum of 60% under 18 years have cardiac rhabdomyomas.
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