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

Abstract

COVID-19 related MIS-C (Multisystem in ammatory syndrome in children) 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 [1,2]. 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) twenty-six days after testing positive for COVID-19. She was treated with IVIG, in iximab, 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) [Fig. 1]. This study emphasizes the importance of early detection and aggressive management of MIS-C to prevent potentially life-threatening consequences.

A Ukrainian infant with giant coronary aneurysms: A case report and literature review

“…We read all 18 literatures hit by this search, and selected 9 case reports which described the acute phase of 11 patients (Table 3). [34][35][36][37][38][39][40][41][42] Among the patients in Table 3, all but one patient received the first IVIG on Day 5 or later. However, IVIG has been administered increasingly earlier for the KD patients in resource-rich countries: for example, 40% of the KD patients receive the first IVIG on Day 4 or earlier in Japan.…”

Navigating the nexus: Exploring COVID-19's influence on cardiovascular risk in Pediatric population

“…Coronary Artery Involvement: Coronary artery dilatation or aneurysms have been reported in severe cases of MIS-C [86]. Long-term coronary problems can be minimized with regular monitoring and early management [86,87].…”