scholarly journals 405: USE OF IMPELLA 5.5 IN A PEDIATRIC PATIENT WITH CARDIOGENIC SHOCK SECONDARY TO VIRAL MYOCARDITIS

2021 ◽  
Vol 50 (1) ◽  
pp. 191-191
Author(s):  
Ramya Deepthi Billa ◽  
Niranjan Vijayakumar ◽  
Yezan Abderrahman ◽  
Heather Elmore ◽  
Aditya Badheka ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Pediatric Patient ◽  
Viral Myocarditis

scholarly journals Case Report: Pediatric Patient with COVID-19 and Multisystem Inflammatory Syndrome in Children

2020 ◽  
Vol 4 (4) ◽  
pp. 513-516
Author(s):  
MacKenzie Burger ◽  
Marcus Moore ◽  
John Wilburn
Keyword(s):  
Case Report ◽  
Risk Stratification ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Pediatric Patient ◽  
Pediatric Patients ◽  
Signs And Symptoms ◽  
Unique Case ◽  
Venoarterial Extracorporeal Membrane Oxygenation ◽  
Inflammatory Syndrome

Introduction: Coronavirus disease 2019 (COVID-19) rarely manifests with severe complications in pediatric patients. An association between COVID-19 and a Kawasaki-like inflammatory syndrome has recently presented in pediatric patients. Case Report: We report a unique case of multisystem inflammatory syndrome in children presenting with characteristic findings in a child who later developed cardiogenic shock requiring venoarterial extracorporeal membrane oxygenation. Conclusion: Recognition of these early signs and symptoms facilitates screening and risk stratification of pediatric COVID-19 cases associated with increased morbidity.

Use of the Impella 5.0 Device as a Bridge to Recovery in Adult Fulminant Viral Myocarditis

2015 ◽  
Vol 10 (4) ◽  
pp. 279-281 ◽  
Author(s):  
Daniel J.P. Burns ◽  
Mackenzie A. Quantz
Keyword(s):  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
Viral Myocarditis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Circulatory Support ◽  
Cardiac Intensive Care Unit ◽  
Ventricular Ejection Fraction ◽  
St Elevation ◽  
Cardiac Intensive Care

We present a case of a 48-year-old female patient successfully bridged to recovery with the Impella 5.0 microaxial pump (Abiomed, Danvers, MA USA) after presenting with cardiogenic shock secondary to acute fulminant viral myocarditis. After 1 week of flu-like symptoms, the patient presented to her community emergency department with chest pain and hypotension. A diagnosis of inferior ST elevation myocardial infarction was made; subsequent angiography demonstrated normal coronary arteries and a left ventricular ejection fraction of 10%. A provisional diagnosis of viral myocarditis was made. As her condition deteriorated further, she underwent insertion of an Impella 5.0 after failure of supportive medical therapy. Myocardial recovery occurred, and the Impella was removed after 1 week. After a prolonged cardiac intensive care unit stay requiring temporary hemodialysis, the patient recovered sufficiently to tolerate device explant, transfer to the recovery ward, and ultimate discharge home. This case report highlights the benefit of mechanical circulatory support in a patient with cardiogenic shock from viral myocarditis as well as some of the complications that can occur in this critically ill subset of patients.

scholarly journals Case Report: Lymphohistiocytic Myocarditis With Severe Cardiogenic Shock Requiring Mechanical Cardiocirculatory Support in Multisystem Inflammatory Syndrome Following SARS-CoV-2 Infection

2021 ◽  
Vol 8 ◽  
Author(s):  
Xavier Bemtgen ◽  
Karin Klingel ◽  
Markus Hufnagel ◽  
Ales Janda ◽  
Christoph Bode ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Cardiogenic Shock ◽  
Life Support ◽  
Immune Cell ◽  
Immunosuppressive Treatment ◽  
Viral Myocarditis ◽  
Adult Patients ◽  
High Dose ◽  
Severe Cardiogenic Shock ◽  
Inflammatory Syndrome

Multisystem Inflammatory Syndrome (MIS) is a novel hyperinflammatory syndrome associated with SARS-CoV-2 infection. It predominantly affects children (MIS-C) a few weeks after a usually asymptomatic SARS-CoV-2 infection and is only rarely seen in adults above 21 years (MIS-A). Only scarce data on histological findings in both pediatric and adult patients has been published so far. An 18-year-old male patient was admitted to hospital in a febrile state, which progressed to severe cardiogenic shock and multi-organ failure requiring extracorporeal life support. Myocardial biopsy revealed small vessel-associated immune cell infiltrates. Diagnosis of MIS-C was made after ruling out all potential differential diagnosis. Use of immunosuppressive treatment with steroids, interleukin-1 blockade and high-dose intravenous immunoglobulins resulted in the patient's full recovery. Multisystem Inflammatory Syndrome (MIS) is a new differential diagnosis of cardiac dysfunction in pediatric and adult patients. The lack of myocardial necrosis differentiates the disease from other viral myocarditis and offers an explanation for the fast response to immunomodulatory therapy and the favorable prognosis. The preceding SARS-CoV-2 infection might only have been mildly symptomatic or even asymptomatic.

scholarly journals COMPLEMENT INHIBITION FOR THE TREATMENT OF COVID-19 TRIGGERED THROMBOTIC MICROANGIOPATHY WITH CARDIAC FAILURE—a case report

2021 ◽  
Author(s):  
Didar Utebay ◽  
Harald Seeger ◽  
Antonia M S Müller ◽  
Sascha David
Keyword(s):  
Cardiogenic Shock ◽  
Thrombotic Microangiopathy ◽  
Viral Myocarditis ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
High Dose ◽  
Severe Thrombocytopenia ◽  
Multisystem Disease ◽  
Complement Inhibition ◽  
Clinical Signs And Symptoms

Abstract Background Severe coronavirus disease 2019 (COVID-19) has been increasingly recognized as a multisystem disease. SARS–CoV-2 can infect literally any cell type that expresses its target receptor angiotensin-converting enzyme 2. However, COVID-19 associated organ dysfunction is not only mediated by direct viral effects but also by the interaction between the host`s immune response, endotheliopathy and microvascular coagulopathy. It has been proposed that the activation of the complement system plays a central role in the pathophysiology of severe COVID-19 and the associated endotheliopathy. Case summary A 76 year-old male patient with indeterminate cardiogenic shock in the setting of confirmed SARS-CoV-2 infection was admitted to our ICU. Coronary angiography did not reveal a plausible explanation for his symptoms. The patient developed renal failure, neurological symptoms, severe thrombocytopenia, and a Coombs-negative hemolytic anaemia with schistocytes. All together the clinical picture was highly suggestive of a thrombotic microangiopathy (TMA) with microvascular cardiac involvement. Conventional therapeutic strategies including high-dose steroids and seven sessions of therapeutic plasma exchange were all unsuccessful. Interestingly, complement inhibition with Eculizumab as rescue approach led to a rapid clinical and laboratory improvement and the patients was discharged with normalized organ functions at day 36. Conclusion The etiology of cardiogenic shock observed in this patient cannot simply be explained by his focal and chronic coronary findings. Although viral myocarditis was not formally excluded, both the clinical features of TMA and the rapid resolution of all clinical signs and symptoms after pharmacological complement inhibition suggest a SARS-CoV-2-driven microangiopathic origin of heart failure.

scholarly journals Myocarditis in COVID-19 presenting with cardiogenic shock: a case series

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Adam Purdy ◽  
Firas Ido ◽  
Stacie Sterner ◽  
Eric Tesoriero ◽  
Tokunbo Matthews ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Treatment Options ◽  
Viral Myocarditis ◽  
Case Series ◽  
Late Presentation ◽  
Cardiac Complications ◽  
Global Pandemic ◽  
Organ Systems

Abstract Background SARS-CoV2, also known as COVID-19, is a specific strain of coronavirus that is responsible for an ongoing global pandemic. COVID-19 primarily targets the respiratory system via droplet transmission, causing symptoms similar to influenza, including fever, cough, and shortness of breath. It is now known to impact other organ systems, causing significant cardiovascular and gastrointestinal illness, among others. Case summary We describe two cases of COVID-19 induced myocarditis presenting with cardiogenic shock. These cases highlight the importance of understanding the lethal cardiac complications of COVID-19 infection, as well as its presentation, diagnosis, pathophysiology, and potential treatment options. These two cases involve patients without underlying cardiovascular disease risk factors who experienced prolonged symptoms of COVID-19 infection. Both patients presented with cardiogenic shock more than one week after symptom onset and diagnosis. These cases demonstrate the late presentation of myocarditis and cardiogenic shock, treated with corticosteroids and inotropes, with subsequent recovery of cardiac function. Discussion The cases highlight the importance of recognizing late presentation viral myocarditis secondary to COVID-19 infection, even in patients without underlying cardiac disease.

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