Lightning strike is rare, with a reported incidence of around 1:100,000. There are few reports of survival after cardiac arrest due to lightning strike. We report the case of a 12-year-old male survivor. Though he had a prolonged out of hospital cardiac arrest and initial poor systolic function, widespread ST segment elevation on electrocardiography, and elevated cardiac troponin I, he survived with a good cardiac and neurological outcome.

We present the case of an infant with Kawasaki disease following persistent complete atrioventricular block, which is a rare cardiovascular complication associated with Kawasaki disease. We offer the importance of careful electrocardiography monitoring during the acute phase of Kawasaki disease.

The content learned in paediatric cardiology fellowship is variable depending on the socio-economic and geographic setting in which training takes place and may result in knowledge gaps. We highlight the key lessons learned from a recent case-based learning session, hosted by Heart University, between two programmes from different geographic and resource settings.

Pulmonary arteriovenous fistulas are a frequent complication after a Kawashima procedure. We present a 15-year-old patient with a significant left pulmonary arteriovenous fistula managed via embolisation using three Micro Vascular Plugs. This technique achieved effective occlusion through the left internal jugular vein, since these are low-profile flexible devices that accommodate through an acute angle without long and stiff sheath.

Although inherited haemoglobinopathies may indicate low oxygen saturation measured by pulse oximetry (SpO2), the timing and mode of its decline after birth are unclear. Here, we present a patient with haemoglobin Köln disease who developed unexpected decline in SpO2 more than two years after heart surgery. Due to simultaneous identification of inferior vena cava stenosis, the differential diagnosis became complicated.

We present an extremely rare case of anomalous single coronary artery from the pulmonary artery in a 2-month-old infant with severe heart failure. Due to the unique coronary anatomy, a modified venous arterial extracorporeal membrane oxygenation technique was employed to maintain coronary perfusion and prevent coronary steal. Following surgical reimplantation, the patient showed significant recovery and remains stable at 2-year follow-up.

Interruption of the aortic arch is a rare congenital cardiac malformation with rare cases described in adulthood. Survival in adulthood relies on developing collateral networks to maintain distal flow. CHD occurs in almost 50% of Turner syndrome and is the most frequent cause of early mortality. Also, they have an increased risk factor for thoracic aortic dilatation, and elective surgery should be considered according to body surface area. Surgical correction is the preferred treatment for the interrupted aortic arch and aortic root dilatation. We present the case of a 46-year-old patient with Turner syndrome with a diagnosis of interrupted aortic arch and aortic root aneurysm who underwent the Bentall procedure and interposition of a Dacron graft in the descending aorta. Post-procedural recovery was uneventful with a good haemodynamic response.

Transcatheter closure of patent ductus arteriosus has an established safety and efficacy in childhood using coils. However, complications and unexpected events are infrequently reported, such as haemolysis, embolisation, and stenosis of the left pulmonary artery or descending aorta. In the current work, we report an unusual obstacle that occurred upon the release of a patent ductus arteriosus coil in a child. Abnormal straightening of the coils on the pulmonary side was encountered, with failure of recoil of the patent ductus arteriosus windings noticed upon the coil release. However, the coil was successfully snared, and another was deployed with an uneventful recovery.

Multisystem inflammatory syndrome in children is a systemic disorder that involves incessant fever, extreme inflammation, and organ dysfunction, which is at first associated with exposure to COVID-19. This case, however, presents a unique twist. A 7-year-old paediatric patient, initially presenting with fever and rash, exhibited a polymorphous rash varying from macular to maculopapular, with a cutis marmorata-like appearance, particularly on the extremities. What followed was a rapid deterioration, with the patient developing tachypnoeic respiration and moderate hypotension (80/35 mm Hg). Elevated D-dimer levels, troponin, ferritin, a low platelet count, a low albumin level, and lymphopenia were detected, further complicating the case. This unique case challenges our understanding of multisystem inflammatory syndrome in children and prompts further investigation.

Despite the severity of the case, the patient’s condition improved significantly with treatment. The patient’s COVID-19 polymerase chain reaction test was negative, but the COVID-19 immunoglobulin G test was positive. Transthoracic echocardiography demonstrated a mild/moderate systolic dysfunction of the left ventricular (Ejection fraction 52%, SF 25%), echogenicity of coronary vessels, and a first-degree mitral insufficiency was detected. Thorax CT showed pulmonary oedema. Milrinone and noradrenaline were promptly started for hemodynamic support. Intravenous immunoglobulin, methylprednisolone, favipiravir, and anakinra were started for his treatment. On the second day of hospitalisation, the patient’s condition was ameliorated. On the 10th day of hospitalisation, the patient was discharged from the hospital, marking a successful recovery from a complex and severe case. This successful recovery serves as a beacon of hope in the management of multisystem inflammatory syndrome in children.

Percutaneous closure of patent ductus arteriosus has become increasingly common with advancements in interventional cardiology, especially in preterm infants. However, complications related to vascular access remain a significant concern, particularly in neonates with low birth weight. We reported a case of a 12-day-old preterm infant born at 33 weeks of gestation, who developed a right external iliac artery injury during catheter-based patent ductus arteriosus closure, necessitating emergent surgical intervention. Postoperatively, the patient recovered without signs of ischaemia or neurologic deficit. This case underscores the importance of careful vascular access planning and highlights the potential for serious complications even in technically successful patent ductus arteriosus closures in neonates.

Transcatheter pulmonary valve replacement (TPVR) is often employed for patients who are poor surgical candidates. We present a case of posterior sternal protrusion into a surgically placed right ventricle to pulmonary artery conduit, making the patient a poor candidate for surgical replacement and leading to significant operator distress during ultimately successful TPVR.

Ventricular assist devices, such as the HeartMate 3, are routinely used to support patents with failing ventricular function. However, extrinsic obstruction of the outflow graft has been identified as a complication associated with the HeartMate 3. We report a case of a patient with transposition of the great arteries (d-TGA), status post-Mustard procedure with severe systemic (right) ventricular dysfunction who developed extrinsic obstruction of theoutflow graft, 6 years after implant, leading to a significant reduction in HeartMate 3 flow. This patient required the placement of multiple stents to fully address the diffuse stenosis of the outflow graft. This case underscores the technical challenges involved in managing extrinsic obstruction of theoutflow graft in patients with this anatomy and highlights the importance of a tailored, multidisciplinary approach. It emphasises the need for careful planning around stent overlap, outflow graft angulation, and catheter and wire positioning in the context of complex anatomical and device-related interactions.

Primary cardiac tumours are rare. We report a patient with right ventricular cavernous haemangioma, in which non-invasive cardiovascular imaging including echocardiography and MRI helped in the diagnosis with a high pretest probability. The patient also had typical slow-fast atrioventricular nodal reentrant tachycardia, which was an incidental finding and not related to the tumour.

The prognosis of neonatal Ebstein’s anomaly requiring early surgery is poor, especially with a circular shunt. We report a critically ill case managed with emergency two-stage Starnes surgery immediately after birth. We hypothesised that the three components of the Starnes procedure, right ventricle exclusion, atrial septal defect creation, and systemic-to-pulmonary shunt, could be organised and reconstructed in a consecutive two-stage strategy to control postoperative circulatory fluctuations.

Protein-losing enteropathy associated with failing Fontan circulation remains a significant challenge in long-term, single-ventricle circulation management. Evidence is very limited regarding medical therapies associated with a reduction in disease severity and morbidity outside of cardiac transplantation. We report a novel experience with remission of recalcitrant protein-losing enteropathy after treatment of Cryptosporidium gastroenteritis with a combination of antimicrobials including nitazoxanide, paromomycin, and azithromycin.

Coarctation of the aorta is characterised by narrowing of the descending aorta and is a rare cause of secondary hypertension in children and young adults. The aortic stenosis lesion is in a special location with severe consequences, and long-term survival is very low, with high rates of disability and mortality, and can be challenging to detect due to its few clinical manifestations. We report a case of a young patient with atrial fibrillation, renal infarction, and acute cerebral infarction, which are consequences of untreated hypertension due to coarctation of the aorta. The purpose of this report is to emphasize the importance of early diagnosis and management of coarctation of the aorta as a cause of secondary hypertension in children and young adults.

This case report describes a rare incidence of innominate artery compression syndrome in a 5-month-old infant, presenting with severe respiratory symptoms. It highlights the diagnostic challenges, the detailed imaging techniques used, and the surgical intervention that resulted in a successful resolution of symptoms, emphasising the importance of early recognition and intervention in paediatric vascular anomalies.