Letter to the Editor

Letter to the Editor: Giant Cardiac Rhabdomyoma with Mixed Atrial Tachycardia and Nonsustained Ventricular Tachycardia in a Newborn with Tuberous Sclerosis

Tanya Kitova1,2https://orcid.org/0000-0001-5836-6599, Polina Angelova3,*https://orcid.org/0000-0002-1481-3630, Ekaterina Uchikova4https://orcid.org/0000-0002-5217-9001, Borislav Kitov5https://orcid.org/0000-0002-0036-9006
Author Information & Copyright
1Department of Anatomy, Histology and Embryology, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
2Medical College, Trakia University-Stara Zagora, Stara Zagora, Bulgaria
3Department of Neurosurgery, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
4Department of Obstetrics and Gynecology, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria
5Clinic of Neurosurgery, Sv Georgi University Hospital, Plovdiv, Bulgaria
*Corresponding author: Polina Angelova, 15A Vassil Aprilov Blvd., Plovdiv 4002, Bulgaria, Department of Neurosurgery, Medical University of Plovdiv, Plovdiv, Bulgaria, Tel: 359-988777763, E-mail: dr.polina.angelova@gmail.com

© Copyright 2023 Ewha Womans University College of Medicine and Ewha Medical Research Institute. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published Online: Apr 30, 2023

We found the article “Giant Cardiac Rhabdomyoma with Mixed Atrial Tachycardia and Nonsustained Ventricular Tachycardia in a Newborn with Tuberous Sclerosis” published by Kyung Hee Kim and Ji-Eun Ban published in your highly valued journal to be really intriguing [1].

The tuberous sclerosis is a rare systemic genetic disease which affects multiple organs and systems and requires precise diagnosis and a multidisciplinary treatment. According to Zhang et al. the prenatal or early postnatal diagnosis provides an opportunity for adequate treatment, which greatly improves the possibility of normal development of the child [2].

We agree with much of what the respected authors have stated. Based on our experience and literature review, we would like to make some clarifications that would further enrich the publication. In the article there is no clear information regarding the sequence and the progress of the pregnancy, the age of the mother as well as weather she has other diseased children. It is not mentioned whether other congenital anomalies (of the brain, kidneys, etc.) are diagnosed prenatally in addition to the cardiac tumor.

It has been reported that the ultrasound examination is not always informative enough regarding cerebral or kidney damage, therefore it is necessary to perform magnetic resonance imaging to identify subependymal lesions, such as giant cell astrocytoma [3]. Prenatal fetal genetic examination is advisable to detect large deletions of TSC2 and PKD1 genes [3].

A parental genetic examination is also required for establishing whether the disease is inherited or occur sporadically. The tuberous sclerosis is inherited in an autosomal dominant manner with high penetrance, which would allow to make a prediction of a possible subsequent pregnancy.

Pregnancies complicated by the presence of maternal or fetal tuberous sclerosis require greater vigilance, and the mechanisms underlying the increased perinatal distress require further studies [2].

It is not clear by the article why an autopsy was not performed on the deceased child, which would certainly have established both the histological nature of the heart tumor and any additional pathological findings, as well as the cause of the fatal outcome of the child.

The mentioned comments in no way detract from the value of the presented publication, which emphasizes the diagnosis and treatment of atrial and ventricular tachyarrhythmias.


Not applicable.

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Author Contribution

Conceptualization: Kitova T

Formal Analysis: Kitova T

Investigation: Uchikova E

Methodology: Uchikova E

Project Administration: Angelova P, Kitov B

Writing – Original Draft: Kitov B

Writing – Review & Editing: Kitova T, Angelova P, Uchikova E, Kitov B

Ethics Approval and Consent to Participate

Not applicable.



Kim KH, Ban JE. Giant cardiac rhabdomyoma with mixed atrial tachycardia and nonsustained ventricular tachycardia in a newborn with tuberous sclerosis. Ewha Med J. 2022; 45((3))e5


Zhang AXD, Liang H, McEwen FS, Tye C, Woodhouse E, Underwood L, et al. Perinatal adversities in tuberous sclerosis complex: determinants and neurodevelopmental outcomes. Dev Med Child Neurol. 2022; 64((10)):1237-1245


Zhang YX, Meng H, Zhong DR, Jiang YX, Dai Q, Zhang H. Cardiac rhabdomyoma and renal cyst in a fetus: early onset of tuberous sclerosis with renal cystic disease. J Ultrasound Med. 2008; 27((6)):979-982


We are pleased to announce the recent appointment of Dr. Sun Huh as the new editor-in-chief, starting in September 2023. Dr. Ryung-Ah Lee, who previously served as editor-in-chief, dedicated over a decade to her role from January 2013 to August 2023. Her diligent efforts were instrumental in establishing a robust and contemporary system for journal submission and publishing.

Dr. Sun Huh, a former President of the Korean Association of Medical Journal Editors (KAMJE), has graciously accepted the position at Ewha Medical Journal. You can explore his mission and goals as the editor-in-chief of EMJ in the editorial featured in this issue.

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