Intracardiac masses in infancy are not common.
Tumors, thrombi and vegetations of
bacterial endocarditis are exceedingly rare in this age group. These masses are seldom diagnosed before the infant's death. Two-dimensional echocardiography is a noninvasive technique that can detect and differentiate intracardiac masses that occur in infants. It can serially detect changes in the size or location of the masses, thus guiding subsequent medical or surgical intervention. An 11-day-old male newborn had suffered from lip and finger nail
cyanosis, and
dyspnea since 2 days old. Physical examination revealed subcostal retractions and no
heart murmur during admission but a grade II/VI
systolic murmur with a sometime grade II/VI continuous murmur which could be heard at the left upper sternal border 3 days after admission. The liver was palpable 2 cm below the right costal margin. The electrocardiogram was normal. The chest X-ray showed a normal sized heart (CTR = 0.58) with decreased pulmonary vascularity. Arterial blood
gases revealed
hypoxemia (PO2 24.1 mmHg) and
metabolic acidosis, even though the patient was receiving O2 at 50%. The two-dimensional echocardiogram from the parasternal long axis view showed an echo-dense
tumor mass in the right ventricular cavity. At autopsy, a complex
congenital heart disease was found. The pathologic findings were:
patent ductus arteriosus (1.0 x 0.5 cm), fenestrated foramen ovale, unopening pulmonary valve with
thrombus (0.3 x 0.2 cm),
right ventricular hypoplasia and
hypertrophy of the right ventricular wall (1 cm in thickness). A ball like, organized and calcified
thrombus, measuring 2.0 x 1.3 x 1.0 cm was found in the right ventricular cavity.(ABSTRACT TRUNCATED AT 250 WORDS)