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Coronary fibromuscular dysplasia presenting as sudden infant death
M Imamura1, S Yokoyama, K Kikuchi
1Department of Pathology and Laboratory Medicine, Hokkaido Children's Hospital and Medical Center, Japan.
Insights
Sudden unexpected infant death was linked to acute myocardial infarction in a 3-month-old. Fibromuscular dysplasia in the coronary artery, potentially triggered by infection, was identified as a key factor.
Area of Science:
- Pediatric Pathology
- Cardiovascular Pathology
- Infant Mortality Research
Background:
- Sudden unexpected infant death (SUID) remains a critical area of pediatric research.
- Understanding the underlying causes of SUID is essential for prevention and intervention strategies.
- Coronary artery abnormalities are infrequently identified in SUID cases.
Observation:
- A 3-month-old male infant presented with sudden unexpected infant death.
- Autopsy revealed acute myocardial infarction as the cause of death.
- Histopathology demonstrated fibromuscular dysplasia (medial fibroplasia) in the left anterior descending coronary artery with thrombus formation.
Findings:
- Extensive arterial lesions were noted, including fibromuscular dysplasia in the coronary artery and mild intimal lesions in the aorta and other major arteries.
- Potential contributing factors identified include asphyxia at delivery and a possible viral infection.
- The case highlights the significance of coronary arterial lesions in the context of SUID.
Implications:
- This case underscores the importance of thorough cardiovascular examination in SUID investigations.
- Fibromuscular dysplasia, though rare in infants, should be considered in cases of unexplained infant cardiac events.
- Further research is warranted to elucidate the role of viral infections and birth complications in the development of arterial lesions leading to SUID.
Abstract:
We report an unusual case of sudden unexpected infant death in a 3-month-old boy who died of acute myocardial infarction. Histopathologic examination showed typical fibromuscular dysplasia (medial fibroplasia) in the left anterior descending coronary artery, with associated thrombus. The thoracic aorta and celiac, superior mesenteric, and renal arteries also revealed mild intimal lesions. In addition to asphyxia at delivery, a viral infection may have provoked these extensive arterial lesions. The significance of coronary arterial lesions in sudden unexpected infant death is discussed.