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主动脉缩窄合并迟发性脓毒症伴室上性心动过速:临床病例回顾

Coarctation of the Aorta and Late-Onset Sepsis With Supraventricular Tachycardia: A Clinical Case Review.

作者信息

Bhatia Sakshi Upendra, Yelkur Pallavi, Ashok Hamritha, R Akshai, Azhagar Nambi Santhi Vaanmathi

机构信息

Paediatrics, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, IND.

出版信息

Cureus. 2024 Jul 29;16(7):e65634. doi: 10.7759/cureus.65634. eCollection 2024 Jul.

DOI:10.7759/cureus.65634
PMID:39205755
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11357739/
Abstract

We report a case of an 11-day-old male infant who presented to our hospital with complaints of breathing difficulty and cough for two days prior to admission. The child had a seizure post-admission which was controlled with phenobarbitone. The child was connected to a mechanical ventilator. The baby also had persistent tachycardia, which upon doing an electrocardiogram (ECG) led to a diagnosis of supraventricular tachycardia (SVT). Additional investigations revealed the existence of late-onset sepsis (LOS), which was treated with appropriate antibiotics. In view of weak femoral pulses with normal brachial pulses, a diagnosis of coarctation of the aorta (CoA) was entertained. The diagnosis was confirmed by an echocardiogram, and the baby was transferred to a higher-level medical center for surgical correction. Regrettably, the baby succumbed to heart failure and shock on the 12th day of life. This case highlights the infrequency of CoA accompanied by SVT. The case delves into the challenges of diagnosing the condition, the necessary medical interventions, and the unforeseen complications that must be considered to reduce mortality in such circumstances.

摘要

我们报告一例11日龄男婴,入院前两日因呼吸困难和咳嗽前来我院就诊。患儿入院后发生惊厥,用苯巴比妥控制。患儿连接了机械通气机。婴儿还持续心动过速,经心电图(ECG)检查诊断为室上性心动过速(SVT)。进一步检查发现存在晚发性败血症(LOS),给予适当抗生素治疗。鉴于股动脉搏动弱而肱动脉搏动正常,考虑诊断为主动脉缩窄(CoA)。超声心动图确诊后,婴儿被转至上级医疗中心进行手术矫正。遗憾的是,婴儿在出生第12天死于心力衰竭和休克。本病例突出了伴有SVT的CoA的罕见性。该病例深入探讨了诊断该病的挑战、必要的医疗干预措施以及在此类情况下为降低死亡率必须考虑的意外并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0376/11357739/fe579cb62ce4/cureus-0016-00000065634-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0376/11357739/52318073cb5f/cureus-0016-00000065634-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0376/11357739/fe579cb62ce4/cureus-0016-00000065634-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0376/11357739/52318073cb5f/cureus-0016-00000065634-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0376/11357739/fe579cb62ce4/cureus-0016-00000065634-i02.jpg

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本文引用的文献

1
Aortic Coarctation Associated With Hypertrophic Cardiomyopathy in a Woman With Hypertension and Syncope: A Case Report With 8-Year Follow-Up.一名患有高血压和晕厥的女性中与肥厚型心肌病相关的主动脉缩窄:一份8年随访的病例报告
Front Cardiovasc Med. 2022 Jan 25;8:818884. doi: 10.3389/fcvm.2021.818884. eCollection 2021.
2
Neonatal supraventricular tachycardia.新生儿室上性心动过速
Indian Pacing Electrophysiol J. 2019 Nov-Dec;19(6):222-231. doi: 10.1016/j.ipej.2019.09.004. Epub 2019 Sep 18.
3
Coarctation of Aorta in Children.儿童主动脉缩窄
Cureus. 2018 Dec 5;10(12):e3690. doi: 10.7759/cureus.3690.
4
Postnatal Outcomes of Fetal Supraventricular Tachycardia: a Multicenter Study.胎儿室上性心动过速的产后结局:一项多中心研究
Pediatr Cardiol. 2017 Oct;38(7):1317-1323. doi: 10.1007/s00246-017-1662-1. Epub 2017 Jun 29.
5
Immunological Defects in Neonatal Sepsis and Potential Therapeutic Approaches.新生儿败血症的免疫缺陷及潜在治疗方法。
Front Pediatr. 2017 Feb 7;5:14. doi: 10.3389/fped.2017.00014. eCollection 2017.
6
Surgical management of aortic coarctation in adolescents and adults.青少年及成人主动脉缩窄的外科治疗
Interact Cardiovasc Thorac Surg. 2017 Mar 1;24(3):430-435. doi: 10.1093/icvts/ivw353.
7
Pulse oximetry screening: a review of diagnosing critical congenital heart disease in newborns.脉搏血氧饱和度筛查:新生儿重症先天性心脏病诊断综述
Med Devices (Auckl). 2016 Jul 11;9:199-203. doi: 10.2147/MDER.S102146. eCollection 2016.
8
Aortic coarctation repair in the adult.成人主动脉缩窄修复术
J Card Surg. 2014 Jul;29(4):512-8. doi: 10.1111/jocs.12367. Epub 2014 Jun 3.
9
Early-onset neonatal sepsis.早发型新生儿败血症。
Clin Microbiol Rev. 2014 Jan;27(1):21-47. doi: 10.1128/CMR.00031-13.
10
Coarctation of the aorta: lifelong surveillance is mandatory following surgical repair.主动脉缩窄:外科修复后必须进行终身监测。
J Am Coll Cardiol. 2013 Sep 10;62(11):1020-5. doi: 10.1016/j.jacc.2013.06.016. Epub 2013 Jul 10.