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一名1型糖尿病七岁儿童的急性心肌梗死:一例罕见病例报告

Acute Myocardial Infarction in a Seven-Year-Old Child With Type 1 Diabetes: A Rare Case Report.

作者信息

Hajaj Hanane, Elouali Aziza, Ghanam Ayad, Rkain Maria, Babakhouya Abdeladim

机构信息

Faculty of Medicine and Pharmacy, Mother and Child Health Laboratory, Mohammed First University, Oujda, MAR.

Department of Pediatrics, Mohammed VI University Hospital, Oujda, MAR.

出版信息

Cureus. 2024 Jun 22;16(6):e62909. doi: 10.7759/cureus.62909. eCollection 2024 Jun.

Abstract

Myocardial infarction (MI) is extremely rare in children and can have different etiologies, including congenital heart defects and Kawasaki disease. Cardiovascular disease (CVD) is the primary cause of death in patients with type 1 diabetes (T1D). Effective management of risk factors like blood pressure, cholesterol, and blood sugar levels is essential for individuals with T1D to mitigate the risk of cardiovascular complications, including MI. We present the case of a seven-year-old child diagnosed with type 1 diabetes one month before this admission, without any other notable medical history, who was admitted to the pediatric emergency department due to chest pain. The symptoms had begun two hours prior to admission. Upon arrival, the patient reported severe and persistent retrosternal constrictive chest pain radiating to the left arm without other associated signs, with a strictly normal clinical examination. An electrocardiogram (ECG) revealed typical ST segment elevation in inferior leads (II, III, and aVF) with reciprocal changes in V1 to V4. Troponin level was elevated at 7254 ng/l. Echocardiography revealed mild dilation of the left coronary artery (4 mm) and the right coronary artery (3 mm), while other radiological and laboratory investigations showed no abnormalities. The patient responded well to treatment with acetylsalicylic acid, clopidogrel, and heparin, resulting in a favorable outcome.

摘要

心肌梗死(MI)在儿童中极为罕见,其病因可能各异,包括先天性心脏缺陷和川崎病。心血管疾病(CVD)是1型糖尿病(T1D)患者的主要死因。对于T1D患者而言,有效管理血压、胆固醇和血糖水平等风险因素对于减轻包括MI在内的心血管并发症风险至关重要。我们报告一例七岁儿童病例,该患儿在此次入院前一个月被诊断为1型糖尿病,无其他显著病史,因胸痛入住儿科急诊科。症状在入院前两小时开始。入院时,患者报告胸骨后严重且持续的压榨性胸痛放射至左臂,无其他相关体征,临床检查完全正常。心电图(ECG)显示下壁导联(II、III和aVF)典型的ST段抬高,V1至V4导联有对应性改变。肌钙蛋白水平升高至7254 ng/l。超声心动图显示左冠状动脉轻度扩张(4 mm),右冠状动脉轻度扩张(3 mm),而其他影像学和实验室检查未发现异常。患者对阿司匹林、氯吡格雷和肝素治疗反应良好,预后良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8625/11262754/3cf98dcc324b/cureus-0016-00000062909-i01.jpg

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