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Myocardial infarction in children: Two interesting cases.

Suryawanshi SP, Das B, Patnaik AN - Ann Pediatr Cardiol (2011)

Bottom Line: Myocardial infarction in children is extremely rare and can have various etiologies.The following two case reports highlight rare but important causes of myocardial infarction in children.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad - 500 082, Andhra Pradesh, India.

ABSTRACT
Myocardial infarction in children is extremely rare and can have various etiologies. The following two case reports highlight rare but important causes of myocardial infarction in children.

No MeSH data available.


Related in: MedlinePlus

Electrocardiogram showing extensive anterior wall myocardial infarction (evolved)
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Figure 1: Electrocardiogram showing extensive anterior wall myocardial infarction (evolved)

Mentions: A 12-year-old boy was diagnosed as nephrotic syndrome (minimal change disease) since the age of 7 years. He was on steroids for the last 4 years and had a satisfactory response. He presented with breathlessness, with episodes of paroxysmal nocturnal dyspnoea of 1 week duration. There was no chest pain. He was admitted to the emergency ward and treated for left ventricular failure (LVF). He was also detected to have right hemiplegia with aphasia. The electrocardiogram showed typical ST elevation and pathological Q waves consistent with acute anteroseptal MI [Figure 1]. A two-D echocardiogram revealed dilated left atrium and left ventricle (LV). There was severe LV systolic dysfunction with hypokinesia of the left anterior descending (LAD) territory. Troponin-T test was positive. Creatinine kinase-MB was in the normal range. A computed tomography (CT) scan of the brain showed recent infarct in the left fronto-temporo-parietal lobe. Catheterization studies showed no evidence of any significant atherosclerotic coronary artery disease [Figure 2]. The carotid arteries on both the sides were normal. Other investigations were: lipid profile - total cholesterol, 195 mg/dl, low-density lipoprotein (LDL) cholesterol, 118 mg/dl, triglycerides (TG), 191 mg/dl, high-density lipoprotein (HDL) cholesterol, 38 mg/dl, very low density lipoprotein (VLDL) cholesterol, 38 mg/dl, significant proteinuria (albuminuria), serum hypoalbuminemia and thrombocytosis (platelet count, 9.3 lakhs/ml). The serum homocysteine, rheumatoid factor IgM, anti-nuclear antibody, anti-double-stranded DNA and anti-cardiolipin-IgM and IgG levels were in the normal range. His heart failure and hemiparesis improved over 1 week on conservative management with diuretics, antiplatelets (aspirin and clopidogrel), nitrates, statins and low-molecular weight heparin. He was discharged in a stable hemodynamic condition.


Myocardial infarction in children: Two interesting cases.

Suryawanshi SP, Das B, Patnaik AN - Ann Pediatr Cardiol (2011)

Electrocardiogram showing extensive anterior wall myocardial infarction (evolved)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3104543&req=5

Figure 1: Electrocardiogram showing extensive anterior wall myocardial infarction (evolved)
Mentions: A 12-year-old boy was diagnosed as nephrotic syndrome (minimal change disease) since the age of 7 years. He was on steroids for the last 4 years and had a satisfactory response. He presented with breathlessness, with episodes of paroxysmal nocturnal dyspnoea of 1 week duration. There was no chest pain. He was admitted to the emergency ward and treated for left ventricular failure (LVF). He was also detected to have right hemiplegia with aphasia. The electrocardiogram showed typical ST elevation and pathological Q waves consistent with acute anteroseptal MI [Figure 1]. A two-D echocardiogram revealed dilated left atrium and left ventricle (LV). There was severe LV systolic dysfunction with hypokinesia of the left anterior descending (LAD) territory. Troponin-T test was positive. Creatinine kinase-MB was in the normal range. A computed tomography (CT) scan of the brain showed recent infarct in the left fronto-temporo-parietal lobe. Catheterization studies showed no evidence of any significant atherosclerotic coronary artery disease [Figure 2]. The carotid arteries on both the sides were normal. Other investigations were: lipid profile - total cholesterol, 195 mg/dl, low-density lipoprotein (LDL) cholesterol, 118 mg/dl, triglycerides (TG), 191 mg/dl, high-density lipoprotein (HDL) cholesterol, 38 mg/dl, very low density lipoprotein (VLDL) cholesterol, 38 mg/dl, significant proteinuria (albuminuria), serum hypoalbuminemia and thrombocytosis (platelet count, 9.3 lakhs/ml). The serum homocysteine, rheumatoid factor IgM, anti-nuclear antibody, anti-double-stranded DNA and anti-cardiolipin-IgM and IgG levels were in the normal range. His heart failure and hemiparesis improved over 1 week on conservative management with diuretics, antiplatelets (aspirin and clopidogrel), nitrates, statins and low-molecular weight heparin. He was discharged in a stable hemodynamic condition.

Bottom Line: Myocardial infarction in children is extremely rare and can have various etiologies.The following two case reports highlight rare but important causes of myocardial infarction in children.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad - 500 082, Andhra Pradesh, India.

ABSTRACT
Myocardial infarction in children is extremely rare and can have various etiologies. The following two case reports highlight rare but important causes of myocardial infarction in children.

No MeSH data available.


Related in: MedlinePlus