Mystkowska Dominika, Galeczka Michal, Tarala Wojciech, Banaszak Pawel, Sliwka Joanna, Pawlak Szymon, Fiszer Roland
Department of Pediatric Cardiology and Congenital Heart Defects, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland.
Department of Pediatrics and Pediatric Gastroenterology, College of Medical Sciences, University of Rzeszow, Rzeszow, Poland.
Front Cardiovasc Med. 2024 Mar 13;11:1327996. doi: 10.3389/fcvm.2024.1327996. eCollection 2024.
We present a case of a 22-month-old boy with a hypokinetic and thin-walled aneurysm of the left ventricle apex. The lesion was diagnosed during routine echocardiography examination in the course of MIS-C, and its occurrence due to MIS-C is plausible. Cardiac magnetic resonance imaging revealed an akinetic aneurysm of the LV apex with a full-wall ischemic scar. Aortography confirmed a normal course of coronary arteries, with adequate perfusion of essential branches and no evidence of stenosis or aneurysms. The boy underwent consultation with the heart team and was deemed eligible for surgery. The aneurysm was excised up to the margin of healthy tissues, and both the surgery and the periprocedural period were uneventful. Determining the origin of the aneurysm is challenging. The most probable etiology appears to be a congenital lesion. Another consideration is an ischemic lesion that may have resulted from impaired coronary circulation during the complicated course of MIS-C. It is possible that this disturbance resolved spontaneously before aortography was performed. Additionally, a complication of pericarditis cannot be entirely ruled out.
我们报告一例22个月大的男孩,其左心室心尖部存在运动减弱且壁薄的动脉瘤。该病变是在多系统炎症综合征(MIS-C)病程中的常规超声心动图检查时被诊断出来的,且其由MIS-C引发是有可能的。心脏磁共振成像显示左心室心尖部有运动不能性动脉瘤,伴有全层缺血性瘢痕。主动脉造影证实冠状动脉走行正常,主要分支灌注充足,无狭窄或动脉瘤迹象。该男孩接受了心脏团队的会诊,并被认为适合手术。动脉瘤被切除至健康组织边缘,手术及围手术期过程均顺利。确定动脉瘤的起源具有挑战性。最可能的病因似乎是先天性病变。另一种考虑是在MIS-C的复杂病程中,可能因冠状动脉循环受损导致的缺血性病变。有可能这种紊乱在进行主动脉造影之前就自发缓解了。此外,心包炎的并发症也不能完全排除。