Neonatal myocardial infarction is a rare clinical entity that is associated with high mortality. Reported treatment strategies include supportive care, extracorporeal membrane oxygenation, thrombolytics, and surgical thrombectomy. Herein we report a neonate who developed an acute myocardial infarction owing to a thrombus in the proximal left coronary artery. At 24 hours of life, he was treated with local (intracoronary) thrombolytic therapy at a lower dose than previously reported, as well as with systemic anticoagulation. There was subsequent angiographic resolution of the thrombus and normalisation of left ventricular function.

Torsades de Pointes is an extremely rare arrhythmia in children associated to LQT syndrome. Pheochromocytomas are also extremely rare tumours in the paediatric age. We present a case of a young patient with an acquired long QT syndrome complicating with Torsades de Pointes as first clinical manifestation of a pheochromocytoma.

We report a case of unroofed coronary sinus not associated with the persistent left superior vena cava. Definite diagnosis of the unroofed coronary sinus was obtained by trans-oesophageal echocardiography, which revealed the unroofed portion with left-to-right shunt. Real-time three-dimensional trans-oesophageal echocardiography could show the whole pictures of the defect, which was useful information for surgical repair.

The window duct is a rare congenital anomaly that is physiologically similar to an aortopulmonary window but is extrapericardial at the distal pulmonary trunk. The diagnosis is challenging, and surgical management is complex. Our patient is the first and the youngest to be reported with successful closure and diagnosed by magnetic resonance imaging.

Patients with cardiomyopathy have a higher incidence of mood and anxiety disorders, resulting in greater probability for hospitalisation and increased risk for arrhythmia and death. We report a case of a 16-year-old boy with Danon disease, Wolff–Parkinson–White syndrome, and hypertrophic cardiomyopathy, who later developed depression and significant weight loss. The patient was successfully treated for his anxiety and depression with mirtazapine without any adverse cardiac effects.

We present a case of severe aortic coarctation in a donor of twin–twin transfusion syndrome. Patients underwent two angioplasty procedures at age 7 and 47 days, weighing 900 and 1500 g, respectively. Umbilical artery approach was used in the first procedure, and femoral artery approach was used in the second. Follow-up at the age of 13 months showed no recurrence of coarctation.

Atrioventricular valve regurgitation is widely known as a risk factor for Fontan completion in patients with univentricular physiology. To date, indications and timing for atrioventricular valve repair remain unclear and different surgical techniques have been advocated. Since 2013, 50 consecutive patients underwent extracardiac Fontan completion in our institution. Atrioventricular valve repair, by avoiding the use of a prosthetic ring, was performed as a concomitant procedure in three of them, with excellent short-term results. Beating-heart repair was performed in one of the patients with hypoplastic left heart syndrome as the underlying disease. Valve repair when moderate or severe regurgitation is present may be performed at a low risk. Both the staged approach of atrioventricular valve repair followed by the Fontan as a separate operation and the combined approach of simultaneous atrioventricular valve repair and Fontan have a role in the management of these complex patients. We highlight the importance of the use of “easy and simple” surgical techniques for repairing the atrioventricular valve in order to provide a better life prognosis in Fontan patients.

We report on a 6-year-old boy with a huge right coronary artery to the right ventricle fistula, who had previously been treated by device closure at the right ventricular exit point. However, 3 years later, the right coronary artery aneurysm showed progressively dilation and compressed the right ventricle. To prevent further complications related to the aneurysm, the proximal part of the aneurysm was successfully occluded by a vascular plug.

Heart failure is a common cause of death in patients with muscular dystrophy. Mechanical support may be an important component of long-term heart failure therapy in these patients. We present a report of a child with muscular dystrophy successfully implanted with a Heartware HVAD.

A 20 year-old woman presented with systemic embolisation. On subsequent investigation, she was diagnosed with a congenital left atrial appendage aneurysm. Few case reports are reported in the literature. This cardiac malformation presents a diagnostic challenge in patients with cardiomegaly.

An aberrant right subclavian artery arising from a left aortic arch is the most frequently described congenital aortic arch anomaly, occurring in 0.5 to 2.3% of the general population. Despite the retro-oesophageal course of the aberrant subclavian artery, an arterio-oesophageal fistula is an uncommon finding, only previously reported as a very rare complication in critically ill patients with oesophageal instrumentation or foreign body ingestion. We describe a unique case of a spontaneous aberrant right subclavian arterio-oesophageal fistula without an inciting event in a 17-month-child.

We describe a case of influenza A myocarditis and transient left ventricular wall thickening in a 14-year-old girl presenting with acute heart failure. Admission echocardiogram revealed significant left ventricular hypertrophy with depressed left ventricular systolic function. The aetiology of the ventricular thickening was demonstrated to be myocardial oedema using cardiac magnetic resonance imaging. The natural course of this unusual clinical presentation of acute myocarditis and the importance of cardiac magnetic resonance imaging in this challenging clinical setting are discussed.

We present a case of a previously healthy adolescent male for outpatient evaluation of prolonged QT interval. He was ultimately found to have acquired QT interval prolongation secondary to hypocalcaemia related to undiagnosed hypoparathyroidism. This case report highlights the importance of routine electrolyte analysis, even in the outpatient setting, during initial diagnostic workup for QT interval prolongation.

Long QT syndromes encompass the most prevalent group of ion channelopathies. Long QT syndromes are predominantly familial and predispose the affected individual to ventricular arrhythmias and sudden death. Permanent pacemaker insertion for long QT syndrome is discouraged apart from younger patients exhibiting 2:1 atrioventricular block. However, permanent pacemaker insertion is a relatively common procedure in neonates with atrioventricular block, and dual-chamber permanent pacemaker insertion in low birth weight infants is challenging. We describe the management of long QT syndrome − type 2 − presenting in an extremely preterm neonate including epicardial, dual-chamber permanent pacemaker insertion.

Common aetiologies of sudden cardiac death in children include coronary anomalies, channelopathies, and cardiomyopathies. Less frequently, hypercoagulable states cause sudden arrest. We report an unusual case of aborted sudden cardiac death in a teenager, ultimately found to have homozygosity for the 4G allele of the plasminogen activase inhibitor type 1 gene.

The CentriMag ventricular assist device is an extracorporeal, third-generation, continuous flow device. The rapidity and simplicity of operation along with low priming volume make it attractive for use in children with refractory heart failure. We report the successful use of CentriMag as a bridge to recovery in a child and discuss issues that are unique to its use in children.

We report a unique case of compression of the superior caval vein by an aneurysmal right pulmonary artery in a patient with tetralogy of Fallot with absent pulmonary valve.

We report about a 12-year-old girl who presented with a blood pressure difference between the extremities with the suspicion of an aortic coarctation. After imaging and laboratory tests, the diagnosis of Takayasu arteritis was made. Owing to persistent arterial hypertension despite medical treatment, we initiated a treatment with a balloon angioplasty of the renal arteries with an eluting balloon.