Discussion:
Our 10 week old female infant was a unique case as she was asymptomatic
until she was 9 weeks old. It is unclear as to what specifically caused
her to have cardiac arrest. We also suspect that when the baby limped
and cried with sudden increase of intrathoracic pressure the cystic
compoment of the mass might have ruptured to aggravate the pericardial
effusion and precipitated the tamponade, resulting in cardiac arrest. It
is equally possible that the large pericardial effusion found in bedside
echocardiogram may have caused electric conduction disruptions in her
heart leading to cardiac arrest. Review of the literature showed no case
reports detailing an otherwise healthy infant presenting with cardiac
arrest as a result of a cardiac mass. This case highlights the
importance of close prenatal screening and to have a high suspicion for
intrapericardial masses as a possible cause of cardiac arrest. Early
identification allows for interventions such as pericardiocentesis, or
thoraco/pericardio-amniotic shunt to be done in-utero allowing for
prolongation of pregnancy2,5,8. On echocardiogram a
patent foramen ovale with a small shunt was present, which may have
prevented symptoms from presenting earlier.