Giant Coronary Aneurysms in Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 Infection

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Inflammatory Syndromes

Background:

• Multisystem Inflammatory Syndrome in Children (MIS-C) is a serious condition that can affect multiple organs, including the heart.
• Cardiac involvement in MIS-C frequently includes coronary artery abnormalities, such as dilation and aneurysms.
• Giant coronary aneurysms are an uncommon but severe manifestation of MIS-C.

Observation:

• This report describes three pediatric patients diagnosed with MIS-C who developed giant coronary aneurysms.
• One patient represents the youngest reported case of giant coronary aneurysms associated with MIS-C.
• The patients presented with significant cardiac sequelae requiring intensive management.

Findings:

• Successful treatment was achieved using a combination of intravenous immunoglobulin, corticosteroids, and biologic agents.
• The therapeutic approach demonstrated efficacy in managing the severe coronary artery pathology.
• Early recognition and multimodal treatment are crucial for favorable outcomes.

Implications:

• This case series expands the understanding of MIS-C's potential cardiac impact, particularly concerning giant coronary aneurysms.
• The findings support the use of combined immunomodulatory and biologic therapies in refractory cases.
• Further research is warranted to elucidate long-term outcomes and optimize management strategies for MIS-C-associated giant coronary aneurysms.