Department of Medicine, Montefiore Medical Center, Bronx, NY, USA.
Division of Cardiology, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA.
BMJ Case Rep. 2022 Mar 7;15(3):e247427. doi: 10.1136/bcr-2021-247427.
The SARS-CoV-2 virus has caused a global pandemic with serious impact around the world. Patients most commonly present with severe lung involvement and acute respiratory failure; however, multisystem inflammatory syndrome in adults (MIS-A) is a known-although rare-complication. We present a case of a 49-year-old patient who presented with combined cardiogenic and vasodilatory shock and was diagnosed with MIS-A. He initially required venoarterial extracorporeal membrane oxygenation and Impella for haemodynamic support but was able to be weaned off these devices with complete recovery of left ventricular systolic function. This case demonstrates that MIS-A may present as haemodynamic collapse in adults, but complete recovery is possible with proper haemodynamic support.
新型冠状病毒(SARS-CoV-2)已在全球范围内引发大流行,造成严重影响。患者最常出现严重肺部受累和急性呼吸衰竭;然而,成人多系统炎症综合征(MIS-A)是一种已知的(尽管罕见)并发症。我们报告了一例 49 岁患者,他出现了心源性和血管扩张性休克,并被诊断为 MIS-A。他最初需要接受静脉动脉体外膜肺氧合(VA-ECMO)和 Impella 以支持血液动力学,但通过适当的血液动力学支持,他成功地脱离了这些设备,左心室收缩功能完全恢复。该病例表明,MIS-A 可能在成人中表现为血液动力学崩溃,但通过适当的血液动力学支持,完全康复是可能的。