PIMS-TS – co o nim wiemy

2020 ◽  
Vol 24 (2) ◽  
Author(s):  
Katarzyna Lech-Badłak
Keyword(s):  
Heart Failure ◽  
Immune System ◽  
Kawasaki Disease ◽  
Cardiovascular System ◽  
Clinical Picture ◽  
Multidisciplinary Team ◽  
Cardiac Complications ◽  
Medical Terminology ◽  
Molecular Tests ◽  
Inflammatory Syndrome

Peadiatric inflammatory multisystem syndrome associated with COVID-19 is a new term that describes the COVID-19-associated multi-system inflammatory syndrome in children, which appeared in medical terminology with the spread of the SARS-CoV-2 pandemic. The connection with a past SARS-CoV-2 infection can usually be demonstrated by means of laboratory and molecular tests. The course of the disease is associated with dysfunction of the immune system, hence the clinical picture may be very similar to Kawasaki disease (initially this syndrome was called 'Kawasaki disease-like'). Cardiac complications, including heart failure, were also observed in PIMS. Therefore, cardiological diagnostics is necessary in every child diagnosed with PIMS. Moreover, it should be noted that a patient diagnosed with PIMS should be under the supervision of a multidisciplinary team of doctors. Both the treatment od PIMS and the clinical picture are similar to the treatment of Kawasaki disease. It is mainly based on the use of intravenous immunoglobulin, anticoagulants, and sometimes also glucocorticosteroids. After treatment, cardiological control is necessary due to possible complications in the cardiovascular system.

scholarly journals Multisystem Inflammatory Syndrome in an Adult (MIS-A) Successfully Treated with Anakinra and Glucocorticoids

2021 ◽  
Vol 9 (7) ◽  
pp. 1393
Author(s):  
Paolo Cattaneo ◽  
Alessandro Volpe ◽  
Chiara Simona Cardellino ◽  
Niccolò Riccardi ◽  
Giulia Bertoli ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Clinical Picture ◽  
Toxic Shock Syndrome ◽  
Case Series ◽  
Biologic Agents ◽  
Diagnostic Process ◽  
Cytokine Storm ◽  
Toxic Shock ◽  
Inflammatory Syndrome

During the current SARS-CoV-2 pandemic, a novel syndrome termed “multisystem inflammatory syndrome in children” (MIS-C) has emerged. MIS-C was linked to COVID-19 and shared some features with Kawasaki disease and Toxic Shock Syndrome, with a common pathogenetic substrate of hyperinflammation and cytokine storm. Lately, MIS was also described in adults (≥21 years of age) and named “MIS-A”. There is no consensus about the treatment of MIS-A; successful use of glucocorticoids and immunoglobulins has been reported in case series, but more solid evidence is lacking. Furthermore, the role of biologic agents with proven benefits against COVID-19, MIS-C, or Kawasaki disease is still unexplored. In this report, we detail the clinical picture and the diagnostic process that led to the diagnosis of MIS-A in a 27-year-old man, focusing on its treatment with anakinra and glucocorticoids, which resulted in full recovery. To our knowledge, this is the first report of the successful use of anakinra for MIS-A, a drug that has already proven useful in the treatment of refractive cases of MIS-C. Anakinra may also play a pivotal role for the treatment of MIS-A.

scholarly journals The cardiovascular system in patients with diffuse toxic goiter

1995 ◽  
Vol 41 (5) ◽  
pp. 41-46
Author(s):  
F. F. Burumkulova ◽  
G. A. Kotova ◽  
G. A. Gerasimov
Keyword(s):  
Heart Failure ◽  
Thyroid Hormones ◽  
Cardiovascular System ◽  
Clinical Picture ◽  
Toxic Effects ◽  
Symptom Complex ◽  
Toxic Goiter

The lesion of the cardiovascular system is a frequent and serious complication of diffuse toxic goiter, which often comes to the fore in the clinical picture and determines the course and outcome of the disease. To refer to this lesion, R. Kraus introduced the term “thyrotoxic heart” in 1899, and now it refers to the symptom complex of disorders of the cardiovascular system caused by the toxic effects of excess thyroid hormones and characterized by the development of hyperfunction, hypertrophy, dystrophy, cardiosclerosis and heart failure.

scholarly journals Multisystem Inflammatory Syndrome in Children and Adolescents (MIS-C) under the Setting of COVID-19: A Review of Clinical Presentation, Workup and Management

2021 ◽  
Vol 14 ◽  
pp. 117863372110266
Author(s):  
Ayesha Farooq ◽  
Fatima Alam ◽  
Asma Saeed ◽  
Farooq Butt ◽  
Muhammad Azeem Khaliq ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Children And Adolescents ◽  
Past History ◽  
Multiorgan Failure ◽  
Gastrointestinal Symptoms ◽  
Respiratory Illness ◽  
Intravenous Immunoglobulins ◽  
Cardiac Complications ◽  
Inflammatory Syndrome

Earlier in its course, SARS-CoV-2 was primarily identified to cause an acute respiratory illness in adults, the elderly and immunocompromised, while children were known to be afflicted with milder symptoms. However, since mid-April of 2020, latent effects of the virus have begun emerging in children and adolescents, which is characterised by a multisystem hyperinflammatory state; thus, the term Multisystem Inflammatory Syndrome in Children (MIS-C) was introduced by the WHO and CDC. The syndrome manifests itself approximately 4 weeks after COVID-19 infection, with symptoms mimicking Kawasaki Disease and Kawasaki Disease Shock Syndrome. Demographically, MIS-C peaks in children aged 5 to 14 years, with clusters in Europe, North and Latin America seen, later followed by Asia. Although the exact pathophysiology behind the syndrome is unknown, recent studies have proposed a post-infectious immune aetiology, which explains the increased levels of immunoglobulins seen in affected patients. Patient presentation includes, but is not limited to, persistent fever, rash, gastrointestinal symptoms and cardiac complications including myocarditis. These patients also have raised inflammatory markers including C reactive protein, ferritin and interleukin-6. In poorly controlled patients, the syndrome can lead to multiorgan failure and death. The mainstay of treatment includes the use of intravenous immunoglobulins, steroids, immune modulators and aspirin. Adjunct therapy includes the use of low molecular weight heparin or warfarin for long term anticoagulation. Currently very little is known about the syndrome, highlighting the need for awareness amongst healthcare workers and parents. Moreover, with increased cases of COVID-19 as a result of the second wave, it is essential to keep MIS-C in mind when attending patients with a past history of COVID-19 exposure or infection. Additionally, once these patients have been identified and treated, strict follow-up must be done in order carry out long term studies, and to identify possible sequelae and complications.

Update regarding anemia in heart failure

Medic ro ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. 8-13
Author(s):  
Roxana Marcela Sânpălean ◽  
Dorina Nastasia Petra
Keyword(s):  
Heart Failure ◽  
Iron Deficiency ◽  
Multidisciplinary Team ◽  
Significant Proportion ◽  
Life Quality ◽  
Lower Number ◽  
Nutritional Deficiencies ◽  
Cardiac Morbidity ◽  
Appropriate Treatment

Heart failure (HF) is a burden for the healthcare system. The incidence will increase significantly due to the aging of po­pu­la­tion, which is associated with multiple comorbidities. Ane­mia and iron deficiency are common in patients with HF, their etiology being often multifactorial. The screening for anemia and iron deficiency is recommended as soon as pos­si­ble. There are often no targeted investigations, therefore a significant proportion of cases are underdiagnosed. The ma­nagement of patients may focus on identifying and correcting the cause. Anemia can occur due to nutritional deficiencies, infla­m­mation, renal failure, bone marrow dysfunction, neuro­hor­mo­nal activity, treatment and hemodilution. The appropriate the­ra­py for the patients with anemia and HF will contribute to the improvement of life quality. The only recommended iron product is ferric carboxymalose administered by in­tra­venous infusion. Under the appropriate treatment, the pa­tients showed an increase in effort tolerance, with an im­prove­ment in symptomatology and a lower number of hos­pi­ta­li­za­tion days. The management of these cases is handled by a multidisciplinary team consisting of a general prac­ti­tio­ner, a cardiologist and other specialists if the patient has other comorbidities. The role of the general practitioner is essential, as he can perform proper screening, prevention and management, developed by a multidisciplinary team, in order to reduce the cardiac morbidity and mortality.  

Estimation of the Safety of Intraoperative Fluid Therapy during Great Abdominal Surgery in Patients with Coronary Heart Disease

2020 ◽  
Vol 5 (5) ◽  
pp. 158-163
Author(s):  
V. I. Lysenko ◽  
◽  
E. A. Karpenko ◽  
Ya. V. Morozova
Keyword(s):  
Heart Failure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Fluid Therapy ◽  
Troponin I ◽  
Significant Proportion ◽  
Myocardial Damage ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cardiac Complications ◽  
Fluid Regimen

The study of intraoperative fluid therapy tactics has been of great interest over the past few years, especially in people with concomitant coronary heart disease, as they make up a significant proportion of all surgical patients. The purpose of our study was to assess the risk of intraoperative myocardial damage in patients with concomitant coronary heart disease depending on the fluid regimen used based on monitoring of hemodynamic parameters, electrocardiogram and biomarkers of myocardial damage. Material and methods. The study involved 89 patients, who were divided into two groups depending on the tactics of intraoperative fluid therapy – restrictive and liberal. In order to detect cardiac complications at different stages, we assessed biomarkers of myocardial damage Troponin I, NT-proBNP by solid-phase enzyme-linked immunosorbent assay (ELISA). Results and discussion. Analysis of the obtained data showed that MINS (myocardial injury in noncardiac surgery) incidents were diagnosed in 5 patients (11.1%) in the first group and in 6 patients (13.6%) in the second. In patients of both groups there was an increase in NT-proBNP in the dynamics at all stages, and in the 2nd group, with a liberal regimen of intraoperative fluid therapy, it was more pronounced. It should be noted that the obtained values of NT-proBNP in all patients did not differ significantly from those allowed for this age group; such dynamics of NT-proBNP may indicate a relative risk of complications of liberal fluid therapy in patients with baseline heart failure. One of the important points when choosing the mode of fluid therapy in patients with high cardiac risk is the assessment of the initial volemic status and careful monitoring of water balance in the perioperative period with the desire for "zero" balance. The obtained dynamics of laboratory markers of myocardial damage indicates that in patients with a significant reduction in cardiac reserves compensated for heart failure, a restrictive fluid regimen is preferable, which is also confirmed by slight changes in the concentration of biomarkers. Conclusion. Thus, the study demonstrated the relative safety of selected fluid regimens in patients with concomitant coronary heart disease without signs of congestive heart failure

Computer assisted instruction for therapy of heart failure based on simulation of cardiovascular system

1987 ◽  
Vol 9 (1) ◽  
pp. 57-61
Author(s):  
Toshiro Sato ◽  
Akihiro Takeuchi ◽  
Jun Yamagami ◽  
Hareaki Yamamoto ◽  
Shigeaki Akiyama ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular System ◽  
Computer Assisted Instruction ◽  
Computer Assisted ◽  
Assisted Instruction

Cardiac echocardiogram findings of severe acute respiratory syndrome coronavirus-2-associated multi-system inflammatory syndrome in children

2021 ◽  
pp. 1-9
Author(s):  
Ashraf S. Harahsheh ◽  
Anita Krishnan ◽  
Roberta L. DeBiasi ◽  
Laura J. Olivieri ◽  
Christopher Spurney ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pericardial Effusion ◽  
Acute Phase ◽  
Systolic Dysfunction ◽  
Interquartile Range ◽  
High Rate ◽  
Cardiac Complications ◽  
Valvular Regurgitation ◽  
Coronary Artery Abnormalities ◽  
Inflammatory Syndrome

Abstract Background: A novel paediatric disease, multi-system inflammatory syndrome in children, has emerged during the 2019 coronavirus disease pandemic. Objectives: To describe the short-term evolution of cardiac complications and associated risk factors in patients with multi-system inflammatory syndrome in children. Methods: Retrospective single-centre study of confirmed multi-system inflammatory syndrome in children treated from 29 March, 2020 to 1 September, 2020. Cardiac complications during the acute phase were defined as decreased systolic function, coronary artery abnormalities, pericardial effusion, or mitral and/or tricuspid valve regurgitation. Patients with or without cardiac complications were compared with chi-square, Fisher’s exact, and Wilcoxon rank sum. Results: Thirty-nine children with median (interquartile range) age 7.8 (3.6–12.7) years were included. Nineteen (49%) patients developed cardiac complications including systolic dysfunction (33%), valvular regurgitation (31%), coronary artery abnormalities (18%), and pericardial effusion (5%). At the time of the most recent follow-up, at a median (interquartile range) of 49 (26–61) days, cardiac complications resolved in 16/19 (84%) patients. Two patients had persistent mild systolic dysfunction and one patient had persistent coronary artery abnormality. Children with cardiac complications were more likely to have higher N-terminal B-type natriuretic peptide (p = 0.01), higher white blood cell count (p = 0.01), higher neutrophil count (p = 0.02), severe lymphopenia (p = 0.05), use of milrinone (p = 0.03), and intensive care requirement (p = 0.04). Conclusion: Patients with multi-system inflammatory syndrome in children had a high rate of cardiac complications in the acute phase, with associated inflammatory markers. Although cardiac complications resolved in 84% of patients, further long-term studies are needed to assess if the cardiac abnormalities (transient or persistent) are associated with major cardiac events.

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