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Objective: Acute rheumatic fever (ARF) is an endemic disease observed in children of developing countries. The purpose of this study was to test if it was possible to identify myocardial involvement in cases with rheumatic carditis by the measurement of serum cardiac TnT. Methods: 30 patients diagnosed as ARF underwent echocardiography and their cardiac troponin T (cTnT) serum levels were measured. Patients were divided into group 1: Arthritis alone, group 2: carditis, and group 3 carditis with congestive heart failure (CHF). Results: cTnT serum levels were normal in all except one patient with in group 3. Two patients in carditis (group 2) and three patients in CHF (group 3) had dilation in left ventricular end diastolic diameter. Conclusions: Normal cTnT levels in our patient group suggests that inflammation rather than myocardial necrosis is predominant in ARF carditis.

Objective: Children with attention deficit and hyperactivity disorder (ADHD) may have an increased risk of cardiovascular complications due to reduced vagal tone and increased heart rate (HR). Methylphenidate (MPH) is a frequently used drug, and its sympathomimetic effects often cause pediatricians to be concerned when making diagnostic and treatment decisions. We aimed to assess the effects of MPH on the cardiovascular system and autonomic activity of the heart using heart rate variability (HRV) in ADHD patients. Methods: We retrospectively analyzed physical examination, blood pressure (BP), and 24-hour Holter monitoring in 33 patients (9.7±2.6 years) and 36 healthy subjects (9.54±2.8 years). The results of the examinations at the end of the first month of MPH treatment were compared with the pre-treatment findings in the patient group. Results: Systolic and diastolic BP measurements were similar between the groups at diagnosis. The patients showed a mild increase in systolic and diastolic BP after treatment, but the differences were not statistically significant (p=0.059 and p=0.063, respectively). However, increase in heart rate and QTc duration on ECG was statistically significant in the patient group (p=0.001 and

The coronary slow flow phenomenon (CSFP) is an angiographic finding characterized by delayed opacification of epicardial coronary arteries in the absence of stenotic lesion. Herein, we present a 13-year-old boy with recurrent chest pain who was diagnosed with acute ST-segment elevation myocardial infarction associated with CSFP, which has not been reported previously in the pediatric age group. Coronary angiography revealed only the presence of slow flow in the left anterior descending (LAD) coronary artery. Myocardial perfusion scintigraphy revealed a reversible perfusion defect in the LAD territory, which regressed partially at rest and showed complete improvement after dipyridamole infusion. All the symptoms, electrocardiogram abnormalities and cardiac markers returned to normal after dipyridamole treatment during the follow-up. We conclude that CSFP should be kept in mind in the differential diagnosis of chest pain with myocardial ischemia in the pediatric age group.