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病例报告:1例以眼睑水肿为早期表现的心肌致密化不全导致大面积脑梗死及文献复习

Case report: Myocardial noncompaction causing massive cerebral infarction in 1 patient with eyelid edema as an early manifestation and literature review.

作者信息

Ge Pingping, Zhu Yafei

机构信息

Department of Pediatrics, Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.

出版信息

Front Pediatr. 2023 Mar 30;11:1108570. doi: 10.3389/fped.2023.1108570. eCollection 2023.

DOI:10.3389/fped.2023.1108570
PMID:37063673
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10098724/
Abstract

OBJECTIVE

To summarize and analyze the early clinical manifestations, risk factors, treatment and prognosis of myocardial noncompaction in children, and to provide scientific basis for early and effective intervention.

METHODS

Combined with a case of myocardial noncompaction with massive cerebral infarction in a child, the related research reports of myocardial noncompaction in children were analyzed retrospectively.

RESULTS

Myocardial noncompaction in children is cardiomyopathy caused by abnormal myocardial compaction during embryonic development. Feeding intolerance, dyspnea, chest tightness, fatigue, eyelid edema and other non-specific manifestations may occur in the early stage. It is easy to miss the diagnosis and misdiagnosis in clinical diagnosis and treatment, leading to intractable heart failure, nausea and arrhythmia, thromboembolism and even sudden death and other serious complications. Early diagnosis, symptomatic treatment, control of complications and regular follow-up can prevent the occurrence of serious complications and reduce mortality.

CONCLUSION

There is no specific clinical manifestation in the early stage of myocardial noncompaction in children. If it is not detected early and treated symptomatically, the prognosis is poor and the mortality is high. Therefore, clinicians should fully improve the understanding of the early clinical manifestations of this disease, give early diagnosis and early intervention to children, reduce the occurrence of serious complications and improve the survival rate.

摘要

目的

总结分析儿童心肌致密化不全的早期临床表现、危险因素、治疗及预后情况,为早期有效干预提供科学依据。

方法

结合1例儿童心肌致密化不全合并大面积脑梗死病例,对儿童心肌致密化不全的相关研究报道进行回顾性分析。

结果

儿童心肌致密化不全是胚胎发育时期心肌致密化异常所致的心肌病。早期可出现喂养不耐受、呼吸困难、胸闷、乏力、眼睑水肿等非特异性表现。临床诊治中易漏诊、误诊,导致难治性心力衰竭、恶心、心律失常、血栓栓塞甚至猝死等严重并发症。早期诊断、对症治疗、控制并发症及定期随访可预防严重并发症的发生,降低死亡率。

结论

儿童心肌致密化不全早期无特异性临床表现,若不及早发现并对症治疗,预后差、死亡率高。因此,临床医生应充分提高对本病早期临床表现的认识,对儿童尽早诊断、尽早干预,减少严重并发症的发生,提高生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/10098724/113600083e0b/fped-11-1108570-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/10098724/39452b658ab2/fped-11-1108570-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/10098724/a1f00af8a675/fped-11-1108570-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/10098724/b86d5553d7ec/fped-11-1108570-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/10098724/e416d5331c45/fped-11-1108570-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/10098724/6b191c91014c/fped-11-1108570-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/10098724/7656aea85e18/fped-11-1108570-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/10098724/8eff8d9c960e/fped-11-1108570-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/10098724/113600083e0b/fped-11-1108570-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/10098724/39452b658ab2/fped-11-1108570-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/10098724/a1f00af8a675/fped-11-1108570-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/10098724/b86d5553d7ec/fped-11-1108570-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/10098724/e416d5331c45/fped-11-1108570-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/10098724/6b191c91014c/fped-11-1108570-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/10098724/7656aea85e18/fped-11-1108570-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/10098724/8eff8d9c960e/fped-11-1108570-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/10098724/113600083e0b/fped-11-1108570-g008.jpg

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