Successful resolution of left ventricular thrombuses in a patient with MIS-C
Cardiology in the Young
; 32(Supplement 2):S253-S254, 2022.
Article
in English
| EMBASE | ID: covidwho-2062127
ABSTRACT
Background and Aim:
A 15 year old young man with symptoms and signs consistent with MIS-C was admitted to the Intensive Care Unit for inotropic support as he was exhibiting signs of cardiogenic shock. He was previously fit and healthy and he had been exposed to Covid 19 confirmed cases 6-8 weeks prior to becoming unwell. Method(s) The patient received IVIG and steroids as an immuno-modulating regime. On the admission echocardiogram there was a structurally normal heart with large LV thrombuses. The D-Dimers were extremely elevated on admission and the patient received therapeutic heparin infusion. Other prothrombotic causes were excluded. Result(s) The surveillance echocardiogram 24h post admission showed resolution of the thrombuses. The patient never exhibited any signs or symptoms of cardiac ischaemia on the electrocardio-gram or regional wall motion abnormality on the echocardiogram or neurologic impairment and the brain MRI-MRA one week post admission was normal. The patient was discharged home 5 days post admission and on follow ups up to a year after the acute phase remains very well physically and clinically. Conclusion(s) Thromboembolic events are frequently described in COVID-19 patients and in some patients with MIS-C and are the consequence of a hyperinflammatory response and endothelial dysfunction. There might be a potential role of an antiphospholi-pid syndrome secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection as has been proposed. An increase in D-dimer level has been shown to be associated with thromboembolic events, including arterial thrombosis especially in the older population and should be investigated promptly. With the appropriate immunomodulation and antithrombotic treat-ment adverse events are prevented. More studies to assess endothelial function and its role in the MIS-C prothrombotic state are necessary.
MIS-C: Multisystem inflammatory syndrome in children; adolescent; artery thrombosis; brain; cardiogenic shock; case report; clinical article; conference abstract; coronavirus disease 2019; drug combination; drug therapy; echocardiography; electrocardiography; endothelial dysfunction; heart left ventricle; heart muscle ischemia; hospital discharge; human; hyperinflammation; immunomodulation; inotropism; intensive care unit; male; motion; neuroimaging; neurologic disease; nuclear magnetic resonance imaging; pediatric multisystem inflammatory syndrome; side effect; thromboembolism; anticoagulant agent; D dimer; heparin; human immunoglobulin; steroid
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Cardiology in the Young
Year:
2022
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS