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Published on: February 1, 2022
Reversible acute left ventricular dysfunction in accidental strangulation
Sindhu Sivanandan1, Aditi Sinha, Rajnish Juneja
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Insights
Accidental strangulation can cause temporary left ventricular dysfunction in children, mimicking a heart attack. This condition, linked to extreme sympathetic nervous system activation, is reversible with prompt medical care.
Area of Science:
- Pediatric Cardiology
- Critical Care Medicine
- Cardiovascular Physiology
Background:
- Strangulation incidents in children can lead to severe physiological stress.
- Understanding the cardiac impact of strangulation is crucial for pediatric intensive care.
Observation:
- A case report details an 8-year-old boy experiencing cardiogenic shock and pulmonary edema post-strangulation.
- The patient presented with electrocardiogram abnormalities, elevated cardiac enzymes, and global left ventricular hypokinesia.
Findings:
- Acute left ventricular dysfunction was observed, characterized by impaired heart muscle function.
- Hemodynamic status and cardiac function significantly improved within 24 hours.
- Resolution of electrocardiogram findings and left ventricular dysfunction confirmed the reversible nature of the condition.
Implications:
- Accidental strangulation can trigger exaggerated sympathetic responses, leading to acute myocardial dysfunction.
- This cardiac dysfunction can mimic acute myocardial infarction in pediatric patients.
- Prompt recognition and management are vital for favorable outcomes in strangulation-related cardiac events.
Objective:
: To report reversible acute left ventricular dysfunction after accidental strangulation in an 8-year-old boy.
Design:
: Case report.
Setting:
: Pediatric intensive care unit in a tertiary care teaching hospital.
Patient:
: Review of the medical record and clinical course of the patient who developed cardiogenic shock and pulmonary edema after strangulation.
Interventions:
: Mechanical ventilation, monitoring of cardiovascular status, and serial evaluation of cardiac enzymes.
Measurements And Main Results:
: In the acute period, electrocardiogram showed transient global ST elevation with rise of cardiac enzymes and global left ventricular hypokinesia. Hemodynamic status improved over 24 hrs with resolution of electrocardiogram findings and left ventricular dysfunction.
Conclusions:
: Exaggerated sympathetic stimulation due to strangulation can result in acute reversible myocardial dysfunction mimicking myocardial infarction.
