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[Acute myocardial infarction in childhood. Report of 2 cases]
E Gredilla Díaz1, E Rodríguez Pérez, A Pérez Ferrer
1Servicio de Anestesia y Reanimación, Hospital Universitario La Paz., Madrid.
Insights
Agenesis of the left coronary trunk is a rare congenital issue causing acute myocardial infarction in children. Early diagnosis via cardiac catheterization and surgical intervention are crucial for survival.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Agenesis of the left coronary trunk is an extremely rare congenital heart malformation.
- Acute myocardial infarction (MI) in infants and children carries a high mortality rate.
- Common causes of pediatric MI include anomalous left coronary artery origin and Kawasaki disease.
Observation:
- Two pediatric patients presented with acute MI, exhibiting non-specific symptoms like dyspnea and feeding difficulties.
- Diagnosis was confirmed using cardiac catheterization.
- Both patients required surgical intervention: one received a saphenous vein bypass graft, and the other underwent heart transplantation.
Findings:
- This review highlights the critical presentation of acute myocardial infarction in pediatric patients with agenesis of the left coronary trunk.
- Non-specific symptoms in children can mask serious cardiac events like MI.
- Cardiac catheterization is essential for definitive diagnosis of coronary artery anomalies.
Implications:
- Prompt diagnosis and surgical management are vital for improving outcomes in children with this rare condition.
- Increased awareness of coronary artery anomalies as a cause of pediatric MI is warranted.
- Further research into the long-term effects and management strategies for agenesis of the left coronary trunk is needed.
Abstract:
We review two cases of agenesis of the left coronary trunk, a very rare congenital malformation. Both patients presented at our children's hospital with acute myocardial infarction, the mortality rate of which is high in infancy and childhood. The most common causes of myocardial infarction are anomalous origin of left coronary artery and Kawasaki disease. Less common causes are myocarditis and absence of the left coronary artery. The patients' main symptoms of acute myocardial infarction were non-specific--dyspnea and feeding problems--as is usual in acute coronary disease in children. A definitive diagnosis was made by cardiac catheterization. Both patients required surgery: saphenous vein bypass graft in one case and heart transplantation in the second. We describe both cases and review the literature.