Chest pain and ST-segment elevation in a patient with Duchenne muscular dystrophy, what really happened?

Details

Serval ID
serval:BIB_27191BDEB71C
Type
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Collection
Publications
Institution
Title
Chest pain and ST-segment elevation in a patient with Duchenne muscular dystrophy, what really happened?
Title of the conference
Annual Conference Swiss Society for Paediatrics
Author(s)
Mivelaz Y., Di Bernardo S., Meijboom E.J., Sekarski N.
Address
Bern, Switzerland, June 22-23, 2006
ISBN
1424-7860
Publication state
Published
Issued date
2006
Peer-reviewed
Oui
Volume
136
Series
Swiss Medical Weekly
Pages
36S
Language
english
Abstract
Introduction:
Myocardial infarction is rare in children, if it occurs, findings are almost similar to adults. In Ouchenne muscular dystrophy (OMO), ST segment displacement associated with typical chest pain can occur. We report the case of a young boy with OMO presenting symptoms suggestive of myocardial ischemia.
Case report:
7 year old boy, diagnosed with OMO, eoming to the emergency department with complaints of acute chest pain, dyspnoea and anxiety the night before. Clinical examination was not remarkable, with exception of findings of the OMO. ECG showed important ST-segment elevation in right precordial leads. Major increase in troponin 1 42.33 mcg/(normal, <0.04 mcg/I) was found. Echocardiography revealed slight yskinesia of postero-septal wall without decrease in ventricular function. As acute pain had happened more han 12 hours before referral and as the child was asymptomatic, he received anti-platelets therapy. The serum level of troponin 1 declined and the ECG normalised in a few days. Cardiac catheterization did not show any coronary anomaly or eardiac dysfunction. Cardiac biopsy revealed myocardial cell damaged compatible with OMO cardiomyopathy. Tc99m myocardial single-photon emission computed tomography (SPECT) did not show any radionuclide uptake defect.
Conclusions:
ln this particular context of children with OMO, the classical signs of myocardial ischemia could be misleading, standard investigation failed to demonstrate the cause of chest pain and inerease of troponin l, there was also no evidence of myocarditis. Role of late enhancement (LE) signal in eontrast-enhanced MRI in the understanding of the occurring process has to be evaluated.
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Create date
22/10/2010 13:18
Last modification date
20/08/2019 13:05
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