BB looked around the room by the time paramedics pushed him into the hospital’s trauma bay. Gil Wernowskithe first-visit critical care cardiologist.
BB’s blood pressure and heart rate were reassuringly normal, and Mr. Wernowski mentally ran through the list of possible causes of his collapse. Heart rhythm disturbances known as arrhythmias. sepsis, Life-threatening infections. myocarditis, a rare but severe inflammation of the heart wall. Even drug overdoses and Lyme disease.
A pediatric cardiologist should echocardiogram, A test that uses ultrasound to assess the function of the heart.
As the images flashed onto the screen, all at once “heard a gasp, followed by complete silence,” Warnowski recalled.
It presented in terrifying detail the cause of the BB problem and the months of unexplained fatigue, dizziness, and chest pain that preceded it.
The ER team was immediately dispatched to prepare BB and her family for emergency surgery. “We had to act very quickly,” Wernowski said. “I really didn’t know if there was going to be a fatal accident in a few minutes.”
BB’s mother, Shuron Akinwumi, remembers being baffled by the doctor’s words and trying to show the courageous face her younger son so desperately needed. She and her doctor and epidemiologist husband Aiken signed consent forms, answered questions about do-not-resuscitate orders, and sought to address warnings that previously healthy children could die in surgery. Ta.
“Look, I just want you to save my son,” Schron remembers telling doctors before being wheeled into the operating room.
BB’s difficult diagnosis contrasted with his unusually quick recovery. The teenager was sent home in critical condition less than four days after arriving by ambulance.
“He recovered so quickly that I barely had time to talk to him,” Wernowski said.
For several months until he arrived children’s country BB, a basketball player, was experiencing chest pain, numbness in his arms, fatigue and malaise, but mostly avoided talking to his mother and others. His symptoms were “very random,” recalled Shuron, director of patient access at GW Medical College Associates.
When she asks her pediatrician about BB’s chest pain, the doctor tells her he may have pulled a muscle (one of the most common causes of chest pain in children) and puts him on Tylenol. advised to do so. It seemed to work. In previous examinations, doctors found nothing abnormal.
In early August, six weeks before she passed out at the trampoline park, BB was hitting the gym in Maryland with her brother Akintra. During the workout, he complained of dizziness, “tingling and feeling generally unwell,” and then briefly passed out. he called his mother
“I said, ‘Sit down and I’ll come pick you up,'” recalls Shuron. When she arrived, he was sitting on the curb of a parking lot, where he was vomiting. Since BB was wearing a hoodie, Schron thought he might have heat stroke or heat stroke. migraine with aura. During his two years, he had suffered from occasional headaches, usually responding to over-the-counter medications.
When we got home, BB took a short nap. When he said he woke up and didn’t remember going to the gym, Ms. Shuron thought he was joking at first.
When we got home, BB took a short nap. When he woke up and said he didn’t remember going to the gym, Shuron thought he was joking at first. She realized he wasn’t and she called 911. Paramedics examined him. His vital signs were normal, but a paramedic suggested taking him to the National Children’s Hospital.
The two spent six hours in the ER. BB’s memory returned and neurological examination was normal. Shuron was referred to the hospital’s cardiology clinic after being advised to follow up by a pediatrician after an electrocardiogram showed the following symptoms: left ventricular hypertrophyhypertension of the left ventricle, which may be caused by high blood pressure, heart valve problems, or strenuous exercise training.
Shuron said he called BB’s pediatrician, who told him his symptoms could be related to a migraine and advised him to rest.
Six weeks later, about 30 minutes after dropping BB and his cousin off at the trampoline park where Akintra works, her phone rang. A park warden told her that BB was “limped up” during the jump. An ambulance was called. His brother scooped him up and ran to the parking lot to wait for paramedics.
Shuron rushed to the scene and followed an ambulance to Children’s National.
“Do what you gotta do”
BB spoke up as a room full of people silently stared at the images on the screen. “There can be no such thing,” he said in disbelief and horror.big growth A shape like a cauliflower stalk was attached to the heart. It resembled a tree swaying in a hurricane. “It was just a shock,” he said.
The ER cardiologist tried to convey the news calmly, Schron recalls. A strange-looking lump on the left side of BB’s heart was a tumor. Wernofsky told Schron that it was not clear whether it was benign or malignant, but that it needed to be made public immediately.
Wernowski said he was virtually certain the tumor was a tumor. cardiac myxoma —It is a rare mass in adults and even rarer in children. The cardiologist has also seen him for two other ailments in his 38-year career. One is a newborn and the other is her 10 year old.
Myxoma is most often benign, but BB “was in a malignant location. I can’t think of anything more terrifying than jumping on a trampoline,” Warnowski said. The giant tumor could have easily cut off blood flow to BB’s heart, killing him instantly.
“I wanted to reassure her that it was benign, but I couldn’t,” he added. “You won’t know until you take it out.”
“‘Do what you gotta do,'” was Shuron’s answer, Mr. Warnowski recalls. “She really put her stuff together. She was a great advocate for her son.”
Shuron said his most vivid memory was trying to reassure BB. “When someone who barely speaks says, ‘Mommy, I don’t want to die…’,” she said, lowering her voice. “I said, ‘You’re not going to die.’ They do these surgeries every day.”
of Causes of cardiac myxoma, which usually affects the upper chambers of the heart, is largely unknown. It is most commonly diagnosed in women aged 30 to 60 and discovered incidentally during workup for other disorders. About 10% are thought to be caused by symptoms such as: rare genetic disease It’s called Carney syndrome, but like BB, it’s mostly random.
Surgical excision is the preferred treatment for tumors that rarely recur.
Shuron said he spent most of the five hours BB was in surgery watching “Downton Abbey” on his iPad to distract himself. She suspects her husband is “more nervous than I am,” she said. [as a doctor] he knows what can happen. ” Both of them tried to calm their fears and comfort their eldest son.
The operation went well. Later that day, BB came out of the cardiac intensive care unit. Schron remembers asking why so many doctors came to see him, and being told the rarity of the tumor and the speed of recovery prompted the visit. “They kept saying, ‘You’re against this, you’re doing that,'” she said.
However, her reserves of power were not limitless. As her family was driving home from the hospital, Shuron said she had “a real ailment”. “I looked back at him and really felt what had happened,” she swallowed and began to cry. She slept in a chair in her BB’s room for two weeks until BB said to her, “Mom, I’m fine.”
It wasn’t until BB was recovering that his mother learned that he had been experiencing months of symptoms that he rarely spoke about. A few weeks after the operation, he told her mother that he felt much better than he had in years.
BB has resumed playing basketball in her senior year of high school in a few weeks, but currently avoids contact sports and strenuous exercise. He has had open-heart surgery, which will require annual follow-up by a cardiologist for the rest of his life.
For Wernowski, the BB experience, which has been used as a teaching example for junior doctors, is a reminder of the importance of thinking broadly when evaluating symptoms.
Shuron said she had been battling guilt in the months before BB’s collapse that she hadn’t asserted herself enough, which might have led to surgery if the situation hadn’t been so dire. Told.
“I think I should have tried harder,” she said, but Mr. Wernowski and the other doctors insisted there was nothing more she could do. “Now if he says his toenail hurts, I’ll be there. He’s here – that’s the best thing.”
Submit your solved medical riddles to Sandra.boodman@washpost.com. Please do not leave any unresolved issues. To read the mystery so far, wapo.st/medicalmysteries.
