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Four unusual cases of sudden and unexpected cardiovascular death in infancy and childhood
R W Byard1, C L Jimenez, B F Carpenter
1Department of Histopathology, Adelaide Children's Hospital, Australia.
Insights
Sudden cardiovascular death in young children can stem from rare conditions like coronary arteritis, anomalous coronary arteries, sickle cell disease, and aortic aneurysm. Autopsy reviews highlight the importance of accurate diagnosis for these unexpected infant and child deaths.
Area of Science:
- Pediatric Pathology
- Cardiovascular Pathology
- Genetics
Background:
- Sudden and unexpected death in infancy and early childhood presents diagnostic challenges.
- Autopsy reviews are crucial for identifying underlying causes in pediatric fatalities.
- Understanding rare cardiovascular events is vital for public health and genetic counseling.
Observation:
- A ten-year autopsy review identified four unusual cases of sudden death in children.
- Cases included myocardial infarction due to coronary arteritis and anomalous coronary arteries.
- Other cases involved splenic sequestration crisis from sickle cell disease and aortic aneurysm rupture.
Findings:
- Acute myocardial infarction in a 2-year-old due to unsuspected coronary arteritis.
- Sudden death in a 7-month-old from anomalous coronary artery origin.
- Splenic sequestration crisis in a 21-month-old due to undiagnosed sickle cell disease.
- Ruptured dissecting aneurysm of the patent ductus arteriosus in a 2-month-old.
Implications:
- Accurate diagnosis is critical, especially in cases with potential genetic implications.
- These findings underscore the need for vigilance in diagnosing rare pediatric cardiovascular and hematologic conditions.
- Early identification of genetic predispositions can inform family screening and counseling.
Abstract:
Four unusual cases of sudden and unexpected cardiovascular death in infancy and early childhood that were found during a ten-year autopsy review at our institutions are presented. In Case 1, an asymptomatic 2-year-old male, sudden death resulted from an acute myocardial infarct due to occlusion of coronary arteries that had been previously damaged by unsuspected arteritis. Case 2, a previously well 7-month-old male, died from an acute myocardial infarct due to an unsuspected anomalous origin of the coronary arteries from a single, stenotic coronary ostium. Case 3, a previously well 21-month-old black male, died from a splenic sequestration crisis due to undiagnosed sickle cell disease. Case 4, a 2-month-old female with suspected Marfan syndrome, died from a ruptured dissecting aneurysm of a patent ductus arteriosus. Accuracy of diagnosis was of particular importance in the latter two cases because of the possible genetic implications.