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Published on: January 17, 2025
Extensive myocardial calcification in critically ill patients receiving extracorporeal membrane oxygenation: A case
Ming-Liang Sui1, Chang-Jiang Wu2, Ya-Di Yang2
1Department ofCritical Care Medicine, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine, Suzhou 215028, Jiangsu Province, China. sml13451648826@163.com.
Insights
Acute myocardial calcification is a rare, severe complication in critically ill patients. This case highlights potential causes and the importance of timely diagnosis and treatment for improved prognosis.
Area of Science:
- Cardiology
- Critical Care Medicine
Background:
- Myocardial calcification is a rare but serious complication in critically ill patients.
- Prompt treatment is crucial for improving the poor prognosis associated with myocardial calcifications.
Observation:
- A case of acute extensive myocardial calcifications developed in a 17-year-old male after prolonged extracorporeal membrane oxygenation (ECMO) for severe myocarditis and cardiogenic shock.
- Chest computed tomography (CT) confirmed calcifications in the left ventricle walls.
Findings:
- The patient survived and showed improved heart function (NYHA class II) at discharge, with sustained survival and quality of life two years later.
- Analysis of this case and seven others suggests prolonged hemodynamic failure, acidosis, vasopressor use, and renal failure may contribute to myocardial calcifications.
Implications:
- This study provides a reference for the clinical diagnosis and treatment of acute myocardial calcifications.
- Further research is needed to clarify the role of ECMO in the development of myocardial calcifications.
Background:
Myocardial calcification is a rare complication in critically ill patients. The prognosis of myocardial calcifications in critically ill patients is very poor if not treated in a timely manner. We describe a rare case of acute extensive myocardial calcifications due to acute myocarditis after receiving extracorporeal membrane oxygenation (ECMO) support.
Case Summary:
We report a 17-year-old male patient who developed extensive myocardial calcifications while receiving prolonged ECMO support for severe myocarditis and cardiogenic shock. Extensive myocardial calcifications were confirmed by chest computed tomography (CT). Myocardial calcifications were observed in the left ventricle walls on CT examination 10 days after admission. The patient was then discharged with heart function class II on the NYHA classification. Two years later, the patient was still alive with adequate quality of life. We then included this patient and 7 other cases retrieved from the PubMed, Cochrane Library, EMBASE, and MEDLINE databases in our study, in order to provide a reference for the clinical diagnosis and treatment of this disease.
Conclusion:
Multiple causes including prolonged hemodynamic failure, profound acidosis, high vasopressor doses, and acute renal failure may jointly lead to extensive myocardial calcifications. The precise role of ECMO support in the timing and frequency of acute myocardial calcifications deserves further investigation.
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