During winter outbreaks of respiratory syncytial virus bronchiolitis from 2002 to 2004, three infants presented with a presumptive diagnosis of lower respiratory tract infection and wheezing. The clinical condition in two cases was rapidly progressive and precipitated into intractable shock; clinical and instrumental examinations revealed a cardiac origin of their illness. A subacute presentation permitted a cardiological assessment and a proper treatment in the third infant. An abnormal origin of the left coronary artery from the pulmonary trunk was demonstrated in all cases. The concurrent acute airway infection had a catastrophic effect on the underlying cardiovascular anomaly leading to refractory cardiogenic shock and death. CONCLUSION: Admission chest X-ray film and arterial gas analysis can raise the suspicion of cardiac involvement when treating a severe wheezing episode in young infants. Paediatric cardiological evaluation with two-dimensional echocardiography may eventually reveal this rare condition, whereas cardiac catheterisation with aortography remains the standard means of diagnosis.

Piastra, M., Polidori, G., De Carolis, M. P., Tempera, A., Caresta, E., Pulitano', S. M. M., Chiaretti, A., Valentini, P., De Rosa, G., Fatal coronary artery anomaly presenting as bronchiolitis, <<EUROPEAN JOURNAL OF PEDIATRICS>>, 2005; (Agosto): 515-519 [http://hdl.handle.net/10807/23547]

Fatal coronary artery anomaly presenting as bronchiolitis

Piastra, Marco;Polidori, Giancarlo;De Carolis, Maria Pia;Caresta, Elena;Pulitano', Silvia Maria Modesta;Chiaretti, Antonio;Valentini, Piero;De Rosa, Gabriella
2005

Abstract

During winter outbreaks of respiratory syncytial virus bronchiolitis from 2002 to 2004, three infants presented with a presumptive diagnosis of lower respiratory tract infection and wheezing. The clinical condition in two cases was rapidly progressive and precipitated into intractable shock; clinical and instrumental examinations revealed a cardiac origin of their illness. A subacute presentation permitted a cardiological assessment and a proper treatment in the third infant. An abnormal origin of the left coronary artery from the pulmonary trunk was demonstrated in all cases. The concurrent acute airway infection had a catastrophic effect on the underlying cardiovascular anomaly leading to refractory cardiogenic shock and death. CONCLUSION: Admission chest X-ray film and arterial gas analysis can raise the suspicion of cardiac involvement when treating a severe wheezing episode in young infants. Paediatric cardiological evaluation with two-dimensional echocardiography may eventually reveal this rare condition, whereas cardiac catheterisation with aortography remains the standard means of diagnosis.
Inglese
Piastra, M., Polidori, G., De Carolis, M. P., Tempera, A., Caresta, E., Pulitano', S. M. M., Chiaretti, A., Valentini, P., De Rosa, G., Fatal coronary artery anomaly presenting as bronchiolitis, <<EUROPEAN JOURNAL OF PEDIATRICS>>, 2005; (Agosto): 515-519 [http://hdl.handle.net/10807/23547]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/23547
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