与COVID-19相关的儿童心脏病

Emilia Alonso Zurmendi, Federica Badía De Ferrari, Maren Karina Machado Echeverría, Mariángel Ospitaleche, María Catalina Pirez García
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摘要

与COVID-19相关的儿童心脏病是在急性感染期间或在儿童多系统炎症综合征(MIS-C)背景下,以及在既往有或无心脏病的患者中描述的。它有不同的表现:无症状,有补充检查的改变(肌钙蛋白升高,心律失常,影像学改变),严重的形式:心肌梗死,心力衰竭,心源性休克,猝死。我们报告一位患有严重COVID-19的女学生,表现为心脏、消化和呼吸症状。临床病例:10岁女童,致残慢性疾病携带者。在重症COVID-19过程中,她增加了休克和呼吸衰竭,炎症标志物升高,肌钙蛋白升高,心腔扩张,左心室功能受损。她接受无创呼吸辅助、抗生素和全身皮质类固醇治疗。心脏表现逆转,炎症参数降低。讨论:2019冠状病毒病患者心脏常受影响。心脏损伤可能是由于:病毒复制、全身炎症反应、呼吸衰竭或心肌应激。严重程度取决于损伤的程度和炎症反应。心脏受累在符合MIS-C标准的患者中更为常见。大多数可以恢复心脏功能。该病例报告有助于了解SARS-CoV-2感染,儿童出现的严重症状并累及心脏,突出表明需要在儿科人群中通过疫苗进行一级预防。第14天为阴性。血流动力学保持稳定。心电图:窦性心动过速。超声心动图:中度心脏肥大,LVEF 48%,轻度心包积液。治疗:血管紧张素转换酶抑制剂和低分子肝素(等凝)。她没有接受血管活性药物治疗。第17天肌钙蛋白降至206.7 ng/L。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Heart Disease Associated with COVID-19 in Children
: Introduction: Heart disease in children associated with COVID-19 is described during acute infection or in the context of the Multisystem inflammatory syndrome in children (MIS-C), and in patients with and without previous heart disease. It has different manifestations: asymptomatic, with alterations in complementary tests (elevated troponins, arrhythmias, imaging changes), up to severe forms: myocardial infarction, heart failure, cardiogenic shock, sudden death. We report a schoolgirl who had severe COVID-19, with cardiac, digestive, and respiratory manifestations. Clinical case: 10-year-old girl, carrier of disabling chronic disease. In the course of severe COVID-19, she added shock and respiratory failure, elevated inflammatory markers, increased troponins, and dilated cardiac cavities, with functional compromise of the left ventricle. She received non-invasive ventilatory assistance, antibiotics, and systemic corticosteroids. Cardiac manifestations reversed, with a decrease in inflammatory parameters. Discussion: The heart is frequently affected in COVID-19. Cardiac injury may be due to: viral replication, systemic inflammatory response, respiratory failure, or myocardial stress. The severity will depend on the extent of the damage and the inflammatory response. Cardiac involvement is more common in those who meet MIS-C criteria. Most recover cardiac function. The case report contributes to the knowledge of SARS-CoV-2 infection, and the severe forms of presentation with cardiac involvement in children highlight the need to advance in primary prevention by vaccines in the pediatric population. on day 14 was negative. Hemodynamics remained stable. Electrocardiogram: sinus tachycardia. Echocardiogram: moderate cardiomegaly, LVEF 48%, mild pericardial effusion Treatment: angiotensin converting enzyme inhibitors and low molecular weight heparin (isocoagulation). She did not receive vasoactive drugs. Troponin decreased to 206.7 ng/L on day 17.
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