Sui Ming-Liang, Wu Chang-Jiang, Yang Ya-Di, Xia Da-Mei, Xu Tian-Jie, Tang Wei-Bing
Department ofCritical Care Medicine, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine, Suzhou 215028, Jiangsu Province, China.
World J Clin Cases. 2022 May 6;10(13):4214-4219. doi: 10.12998/wjcc.v10.i13.4214.
Myocardial calcification is a rare complication in critically ill patients. The prognosis of myocardial calcifications in critically ill patients is very poor if not treated in a timely manner. We describe a rare case of acute extensive myocardial calcifications due to acute myocarditis after receiving extracorporeal membrane oxygenation (ECMO) support.
We report a 17-year-old male patient who developed extensive myocardial calcifications while receiving prolonged ECMO support for severe myocarditis and cardiogenic shock. Extensive myocardial calcifications were confirmed by chest computed tomography (CT). Myocardial calcifications were observed in the left ventricle walls on CT examination 10 days after admission. The patient was then discharged with heart function class II on the NYHA classification. Two years later, the patient was still alive with adequate quality of life. We then included this patient and 7 other cases retrieved from the PubMed, Cochrane Library, EMBASE, and MEDLINE databases in our study, in order to provide a reference for the clinical diagnosis and treatment of this disease.
Multiple causes including prolonged hemodynamic failure, profound acidosis, high vasopressor doses, and acute renal failure may jointly lead to extensive myocardial calcifications. The precise role of ECMO support in the timing and frequency of acute myocardial calcifications deserves further investigation.
心肌钙化是危重症患者中一种罕见的并发症。危重症患者的心肌钙化若不及时治疗，预后很差。我们描述了一例在接受体外膜肺氧合（ECMO）支持后因急性心肌炎导致急性广泛性心肌钙化的罕见病例。
我们报告一名17岁男性患者，在因严重心肌炎和心源性休克接受长时间ECMO支持期间出现广泛性心肌钙化。胸部计算机断层扫描（CT）证实了广泛性心肌钙化。入院10天后的CT检查显示左心室壁有心肌钙化。该患者随后以纽约心脏协会（NYHA）分级II级心功能出院。两年后，患者仍存活，生活质量良好。我们将该患者及从PubMed、Cochrane图书馆、EMBASE和MEDLINE数据库检索到的其他7例病例纳入我们的研究，以便为该病的临床诊断和治疗提供参考。
包括长时间血流动力学衰竭、严重酸中毒、高剂量血管升压药和急性肾衰竭在内的多种原因可能共同导致广泛性心肌钙化。ECMO支持在急性心肌钙化的发生时间和频率方面的确切作用值得进一步研究。
