Giant coronary aneurysms in an infant: Dilemma of MIS-C

Echocardiography. 2022 Jul;39(7):950-953. doi: 10.1111/echo.15408. Epub 2022 Jun 25.

Abstract

COVID-19 related multisystem inflammatory syndrome in children (MIS-C) can present with cardiovascular complications like shock, arrhythmias, pericardial effusion, and coronary artery dilatation. The majority of MIS-C associated coronary artery abnormalities are dilation or small aneurysms which are transient and resolve in a few weeks. We present here a case of a 3-month-old child who was noted to have giant aneurysms of her coronary arteries (LAD and RCA) 26 days after testing positive for COVID-19. She was treated with IVIG, infliximab, and glucocorticoids along with aspirin, clopidogrel, and enoxaparin. She did not show any signs of coronary ischemia or cardiac dysfunction but continued to have persistent giant coronary artery aneurysms involving the LAD (z-score ∼35) and RCA (z-score ∼30). This study emphasizes the importance of early detection and aggressive management of MIS-C to prevent potentially life-threatening consequences.

Keywords: COVID-19; MIS-C; coronary artery aneurysms; pediatrics.

Publication types

  • Case Reports

MeSH terms

  • COVID-19* / complications
  • Child
  • Coronary Aneurysm* / diagnosis
  • Coronary Aneurysm* / diagnostic imaging
  • Coronary Artery Disease* / complications
  • Female
  • Humans
  • Infant
  • Mucocutaneous Lymph Node Syndrome* / complications
  • Systemic Inflammatory Response Syndrome / complications

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related