The results of this study showed that the diabetic children and adolescents with good metabolic control had diastolic dysfunction when assessed with either conventional or tissue Doppler echocardiography. Also diabetic patients had subclinical LV systolic dysfunction with a normal LVEF which can be detected with 2D speckle tracking echocardiography.

Increased awareness about the association of certain CHD with persistent left SVC and a careful echocardiographic examination can facilitate the diagnosis of persistent left SVC. In addition, precise prior diagnosis of persistent left SVC can prevent complications during surgery.

Umbilical vessel catheterization is a common procedure in Neonatal Intensive Care Units, especially in very low birthweight infants. Rarely, umbilical artery catheters break, and the retained fragments can cause thrombosis, infection, distal embolization, and even death. Herein, we describe a neonate with clinically significant bilateral limb ischemia developing after removal of a broken umbilical artery catheter. He was under vasodilator treatment in addition to fibrinolytic and anticoagulants. The evolution was favourable.

To analyze the role of sensitive cardiac troponin I (scTnI) and high-sensitive troponin T (hscTnT) in the determination of myocardial injury caused by volume and pressure load due to pulmonary hypertension (PH) and to investigate if these markers may be useful in the management of PH in childhood. Twenty-eight patients with congenital heart disease (CHD) with left to right shunt and PH, 29 patients with CHD with left to right shunt but without PH, and 18 healthy children, in total 75 individuals, were included in the study. All cases were aged between 4 and 36 months. Echocardiographic evaluation was performed in all cases, and invasive hemodynamic investigation was performed in 33 cases. Blood samples were obtained from all cases, for the measurement of brain natriuretic peptide (BNP), pro-brain natriuretic peptide (pro-BNP), sensitive cardiac troponin I (scTnI), and high-sensitive troponin T (hscTnT) levels. The mean BNP, pro-BNP, scTnI, and hsTnT levels were statistically significantly higher in patients with PH than in the patients without PH (p < 0.001). A statistically significant positive correlation was determined between pulmonary artery systolic pressure and scTnI and hscTnT levels (r = 0.34 p = 0.01, r = 0.46 p < 0.001, respectively) levels. Pulmonary hypertension determined in congenital heart diseases triggers myocardial damage independently of increased volume or pressure load and resistance, occurring by disrupting the perfusion via increasing ventricular wall tension and the myocardial oxygen requirement. Serum scTnI and hscTnT levels may be helpful markers to determine the damage associated with PH in childhood.

UA, Sarı E. A pediatric case of Ortner's syndrome caused by heritable pulmonary arterial hypertension and review of the literature. Turk J Pediatr 2019; 61: 963-966. An 11-year-old male, who complained of hoarseness and fatigue on effort presented to our institution for evaluation. Left vocal cord paralysis and severe pulmonary hypertension was diagnosed. The patient had an enlarged pulmonary artery due to pulmonary hypertension which was responsible for compression to left vocal cord paralysis causing hoarseness. Ortner's syndrome or cardiovocal syndrome is known as hoarseness due to left vocal cord paralysis secondary to cardiac pathologies. Although hoarseness of voice is frequently encountered in the otorhinolaryngology clinics, pulmonary hypertension related hoarseness is an unusual presentation in childhood.