Coronary Bypass in an Adolescent With Systemic Lupus Erythematosus and Acute Coronary Syndrome

A 12-year-old female with active pediatric juvenile systemic lupus erythematosus presented to the emergency department because of episodes of oppressive central thoracic pain associated with pallor, sweating, and muscle weakness that persisted for >30 minutes. During the last episode, the electro...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2024-03, Vol.153 (3), p.1
Main Authors: Rubio-Granda, Ana, Murias Loza, Sara, Covadonga Fernández Barrio, Bárbara, Menéndez Cuervo, Sergio, Silva Guisasola, Jacobo, Concha-Torre, Andrés
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome - complications
Acute coronary syndromes
Angiography
Child
Computed tomography
Coronary Artery Bypass
EKG
Electrocardiography
Emergency medical care
Female
Heart surgery
Humans
Lupus
Lupus Erythematosus, Systemic - complications
Pediatrics
Sweating
Systemic lupus erythematosus
Thorax
Tomography, X-Ray Computed
Troponin
Troponin T
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Summary:A 12-year-old female with active pediatric juvenile systemic lupus erythematosus presented to the emergency department because of episodes of oppressive central thoracic pain associated with pallor, sweating, and muscle weakness that persisted for >30 minutes. During the last episode, the electrocardiogram revealed alterations in cardiac repolarization coincident with progressive troponin T elevation. An angio computed tomography revealed a 20 mm long complete segmental obstruction of the proximal anterior descending artery that was confirmed by angiography. Because this extensive occlusion did not permit a noninvasive procedure, an off-pump coronary bypass of the internal mammary artery to the anterior descending artery was performed without complication. Six months after the procedure, myocardial function was good. To our knowledge, this is the first case report of an adolescent girl with acute coronary syndrome complicating juvenile systemic lupus erythematosus that was treated with a surgical procedure.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2023-063832