Med Bull Sisli Etfal Hosp. 2022; 56(4): 461-465 | DOI: 10.14744/SEMB.2022.23921

Cardiac Evaluation in Children with Multisystem Inflammatory Syndrome Associated with SARS-CoV-2

Muhammed Karabulut¹, Dogukan Aktas¹, Belma Yasar², Ercument Petmezci³, Nazan Dalgic^2
1Department of Paediatric Cardiology, Paediatric Health and Diseases Clinic of the Hamidiye Etfal Training and Research Hospital, Ýstanbul, Türkiye
²Department of Paediatric Infectious Diseases, University of Health Sciences Türkiye, Paediatric Health and Diseases Clinic of the Hamidiye Etfal Training and Research Hospital, Ýstanbul, Türkiye
³Department of Paediatric Intensive Care, Paediatric Health and Diseases Clinic of the Hamidiye Etfal Training and Research Hospital, Ýstanbul, Türkiye

Objectives: The heart is one of the organs frequently affected by the multisystem inflammatory syndrome in children (MIS-C), associated with severe acute respiratory syndrome coronavirus 2 infection. Cardiac involvement in patients with MIS-C was evaluated with physical examination findings, biochemical test, and cardiological imaging tests. We reported the degree of cardiac involvement in patients with MIS-C.
Methods: In this retrospective study, the complaints, physical examination, and cardiac findings of patients with MIS-C were evaluated.
Results: Sixteen patients (four males and 12 females) with MIS-C were included in the study. The median age was 6 (5–17) years. In patients, palpitations (6%), chest pain (12%), ECG changes (50%), valve insufficiency (50%), low ejection fraction (6%), coronary dilatation (6%), troponin (38%), and d-dimer (88%) elevation were detected. One patient died. Valve insufficiency persisted in 5 (31%) patients.
Conclusion: Severe cardiac involvement can be seen in MIS-C patients. Due to its serious effects on mortality and morbidity, cardiac involvement should be evaluated with cardiac imaging tools such as echocardiography and ECG in all MIS-C patients.

Keywords: MIS-C and heart, COVID-19, Multisystem inflammatory syndrome in children, Myocarditis

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SARS-CoV-2 ile Ýliþkili Multisistem Ýnflamatuar Sendromlu Çocuklarda Kardiyak Deðerlendirme

Muhammed Karabulut¹, Dogukan Aktas¹, Belma Yasar², Ercument Petmezci³, Nazan Dalgic^2
1Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi, Çocuk Kardiyolojisi, Çocuk Saðlýðý ve Hastalýklarý Kliniði, Ýstanbul
²Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi, Çocuk Enfeksiyon Hastalýklarý Anabilim Dalý, Çocuk Saðlýðý ve Hastalýklarý Kliniði, Ýstanbul
³Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi, Çocuk Yoðun Bakým Bölümü, Çocuk Saðlýðý ve Hastalýklarý Kliniði, Ýstanbul

Amaç: Kalp, çocuklarda SARS-CoV-2 enfeksiyonu ile iliþkili multisistem inflamatuar sendromdan (MIS-C) sýklýkla etkilenen organlardan biridir. Çalýþmada, MIS-C'li hastalarda kardiyak tutulum deðerlendirildi.
Metod: Bu retrospektif çalýþmada, MIS-C'li hastalarýn þikayetleri, fizik muayeneleri ve kardiyak bulgularý deðerlendirildi.
Bulgular: MÝS-C'li 16 hasta (4 erkek ve 12 kýz) çalýþmaya dahil edildi. Ortanca yaþ 6 (5-17) yýldý. Hastalarda çarpýntý (%6), göðüs aðrýsý (%12), EKG deðiþiklikleri (%50), kapak yetersizliði (%50), düþük ejeksiyon fraksiyonu (%6), koroner dilatasyon (%6), troponin (%38), ve d-dimer (%88) yüksekliði tespit edildi. Bir hasta öldü. Kapak yetersizliði 5 (%31) hastada devam etti.
Sonuç: Kardiyak erken dönem sonuçlarý çok þiddetli olan MÝS-C'nin geç dönem etkileri hakkýnda yeterli veri bulunmamaktadýr. Önümüzdeki dönemde çocukluk çaðý hastalýklarý arasýnda önemli bir saðlýk sorunu haline gelecek olan MÝS-C'nin anlaþýlmasý için çok daha fazla çalýþmaya ihtiyaç vardýr. (SETB-2021-10-309)

Anahtar Kelimeler: COVID-19, SARS-CoV-2, MIS-C, miyokardit

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