Myocardial Infarction Due to a Giant Coronary Artery Aneurysm in a Child Diagnosed with Coronavirus Disease 2019: A Case Report

Abstract

Myocardial damage, including myocardial infarction and myocarditis, generally causes acute heart failure in patients with coronavirus disease 2019（COVID-19）; however, myocardial infarction rarely occurs in children. Herein, we report a case of acute myocardial infarction with a giant coronary artery aneurysm detected following the diagnosis of COVID-19.

A 7-year-old girl who suffered cardiac arrest following COVID-19 was treated for myocarditis postresuscitation. Following acute treatment, coronary computed tomography（CT）and coronary angiography（CAG）were performed to examine the coronary arteries, which revealed a giant coronary aneurysm and acute and old myocardial infarction. Thus, anticoagulation therapy was initiated.

The presence of diffuse hypokinesis in the acute phase of viral infection led to the conclusion that the patient had myocarditis, but myocardial infarction was found to be the underlying cause. The patient was expected to develop an acute myocardial infarction due to hypercoagulation with COVID-19 because a coronary aneurysm was observed from the onset. Diagnosis of coronary aneurysms by ultrasound has limitations and therefore, coronary CT or CAG is used to closely examine coronary arteries in children.

The addition of a coronary artery aneurysm or acute myocardial infarction as a differential diagnosis and a coronary artery scan should be considered even in heart failure during an acute infection.