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Fatal Arrhythmic Complications of Multisystemic Inflammatory Syndrome (MIS-C) in a Pediatric Patient
Chika C Oragui1, Arthur Dilibe2
1Pediatrics, Pediatric Intensive Care Unit (PICU), Stanford University School of Medicine, Lucile Packard Children's Hospital, Palo Alto, USA.
Insights
Multisystem inflammatory syndrome in children (MIS-C) can cause fatal cardiac arrhythmias, even in healthy adolescents. This rare complication highlights the critical need for cardiac monitoring in pediatric COVID-19 patients.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- The COVID-19 pandemic has led to a novel pediatric syndrome, multisystem inflammatory syndrome in children (MIS-C).
- Cardiac complications, including arrhythmias, are significant concerns in MIS-C, though rare.
- Kawasaki-like disease presentation in children post-COVID-19.
Observation:
- A 14-year-old patient without prior cardiac issues developed severe conduction abnormalities.
- The patient presented with fatal arrhythmias attributed to MIS-C.
- This case highlights an unusual and severe cardiac manifestation of MIS-C.
Findings:
- Cardiac conduction abnormalities and fatal arrhythmias occurred in a pediatric patient with MIS-C.
- The absence of pre-existing cardiac risk factors underscores the potential severity of MIS-C.
- This case adds to the limited literature on MIS-C-associated arrhythmias.
Implications:
- Early cardiac evaluation and monitoring are crucial for pediatric COVID-19 patients.
- Understanding MIS-C's cardiac impact is vital for improving patient outcomes.
- This case emphasizes the need for further research into MIS-C's cardiovascular effects.
Abstract:
In 2019, the emergence of the coronavirus disease 2019 (COVID-19) virus triggered a global pandemic, reminiscent of the magnitude witnessed during the flu pandemic of 1918. Initially, children often presented with either asymptomatic or mild upper respiratory tract infection symptoms. However, in the post-acute phase, a distinct syndrome affecting multiple organ systems emerged, sharing similarities with Kawasaki's disease. This syndrome was later classified as multisystem inflammatory syndrome in children (MIS-C) by the Pediatric Intensive Care Society in April 2020. Notably, cardiac manifestations and complications associated with COVID-19 constitute a significant source of morbidity and mortality, characterized by left ventricular dysfunction, cardiac conduction abnormalities, and arrhythmias. Although cases of arrhythmias with MIS-C are rare in the literature, we present a unique case involving a 14-year-old without known cardiac risk factors who presented with conduction abnormalities and fatal arrhythmias secondary to MIS-C.
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