We have detected that you are using an Ad Blocker. PracticeUpdate is free to end users but we rely on advertising to fund our site. Please consider supporting PracticeUpdate by whitelisting us in your ad blocker.
We have sent a message to the email address you have provided, . If this email is not correct, please update your settings with your correct address.
The email address you provided during registration, , does not appear to be valid. Please update your settings with a valid address before to continue using PracticeUpdate.
Welcome to PracticeUpdate! We hope you are enjoying access to a selection of our top-read and most recent articles. Please register today for a free account and gain full access to all of our expert-selected content.
You can find your saved items on your dashboard, in the "saved" tab.
You've recommended your first item
Your recommendations help us improve our content suggestions for you and other PracticeUpdate members.
You've subscribed to your first topic alert
What does that mean?
Each day, we'll check to see if new items have been published to the topics you're subscribed to, and we'll send you one email with all of the new items from that day.
We'll keep all topic alert notifications available on your dashboard for 30 days, to make sure you don't miss anything.
Lastly, whenever you have unread items in the topics you've subscribed to, the "Alerts" icon will light up in the main menu. Just click on the bell to see your five most-recent, unread notifications.
This retrospective single-center study used multimodality imaging to examine characteristics of 20 pediatric and young adult patients with multisystem inflammation associated with COVID-19. Echocardiographic evaluation was performed on admission, at discharge, and at the day coinciding with worst cardiac function. Patients also underwent cardiac magnetic resonance imaging and cardiac computed tomography. In half of patients, 3D echocardiographic ejection fraction was <55% on admission. Valvular regurgitation was common (identified in 75% of patients), and some patients exhibited small pericardial effusions (10%).
Based on evaluation of 20 patients admitted to a London hospital, these data suggest that patients with multisystem inflammation associated with COVID-19 exhibit a range of cardiac symptoms and should undergo close cardiac monitoring.
This abstract is available on the publisher's site.
Following the peak of the UK COVID-19 epidemic, a new multisystem inflammatory condition with significant cardiovascular effects emerged in young people. We utilized multimodality imaging to provide a detailed sequential description of the cardiac involvement.
METHODS AND RESULTS
Twenty consecutive patients (mean age 10.6 ± 3.8 years) presenting to our institution underwent serial echocardiographic evaluation on admission (median day 5 of illness), the day coinciding with worst cardiac function (median day 7), and the day of discharge (median day 15). We performed cardiac computed tomography (CT) to assess coronary anatomy (median day 15) and cardiac magnetic resonance imaging (CMR) to assess dysfunction (median day 20). On admission, almost all patients displayed abnormal strain and tissue Doppler indices. Three-dimensional (3D) echocardiographic ejection fraction (EF) was <55% in half of the patients. Valvular regurgitation (75%) and small pericardial effusions (10%) were detected. Serial echocardiography demonstrated that the mean 3D EF deteriorated (54.7 ± 8.3% vs. 46.4 ± 8.6%, P = 0.017) before improving at discharge (P = 0.008). Left main coronary artery (LMCA) dimensions were significantly larger at discharge than at admission (Z score -0.11 ± 0.87 vs. 0.78 ± 1.23, P = 0.007). CT showed uniform coronary artery dilatation commonly affecting the LMCA (9/12). CMR detected abnormal strain in all patients with global dysfunction (EF <55%) in 35%, myocardial oedema in 50%, and subendocardial infarct in 5% (1/20) patients.
Pancarditis with cardiac dysfunction is common and associated with myocardial oedema. Patients require close monitoring due to coronary artery dilatation and the risk of thrombotic myocardial infarction.
Multimodality Cardiac Evaluation in Children and Young Adults With Multisystem Inflammation Associated With COVID-19
Eur Heart J Cardiovasc Imaging 2020 Aug 07;[EPub Ahead of Print], P Theocharis, J Wong, K Pushparajah, SK Mathur, JM Simpson, E Pascall, A Cleary, K Stewart, K Adhvaryu, A Savis, SR Kabir, MP Uy, H Heard, K Peacock, O Miller