Xie YY, Li QL, Li XL, Yang F. Pediatric acute heart failure caused by endocardial fibroelastosis mimicking dilated cardiomyopathy: A case report. World J Clin Cases 2023; 11(8): 1771-1781 [PMID: 36970005 DOI: 10.12998/wjcc.v11.i8.1771]
Corresponding Author of This Article
Yao-Ying Xie, MD, MSc, PhD, Research Fellow, College of Clinical Medicine, Inner Mongolia Minzu University, No. 536 Huolinhe Street (West), Tongliao 028000, Inner Mongolia Autonomous Region, China. xieyaoying@vip.qq.com
Research Domain of This Article
Pediatrics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 16, 2023; 11(8): 1771-1781 Published online Mar 16, 2023. doi: 10.12998/wjcc.v11.i8.1771
Pediatric acute heart failure caused by endocardial fibroelastosis mimicking dilated cardiomyopathy: A case report
Yao-Ying Xie, Qiu-Li Li, Xin-Le Li, Fan Yang
Yao-Ying Xie, Xin-Le Li, College of Clinical Medicine, Inner Mongolia Minzu University, Tongliao 028000, Inner Mongolia Autonomous Region, China
Yao-Ying Xie, Fan Yang, Department of Pediatric Medical Center, Soochow University, Affiliated Hulunbuir Hospital, Hulunbuir 021000, Inner Mongolia Autonomous Region, China
Qiu-Li Li, College of Medicine, Shantou University, Shantou 515063, Guangdong Province, China
Fan Yang, School of Medicine, Shihezi University, Shihezi 832000, Xinjiang Uygur Autonomous Region, China
Author contributions: Xie YY contributed to the conception of the report; Yang F contributed to the acquisition of the data and literature; Xie YY was responsible for analyzing and drafting the report; Li QL was responsible for editing the language; Li XL participated in manuscript’s revision and created Figure 4; All authors reviewed and approved the final version of the manuscript.
Informed consent statement: Signed informed consent form was obtained from the patient for publication of this report. And all the real name information related to the patients had been de-identified.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yao-Ying Xie, MD, MSc, PhD, Research Fellow, College of Clinical Medicine, Inner Mongolia Minzu University, No. 536 Huolinhe Street (West), Tongliao 028000, Inner Mongolia Autonomous Region, China. xieyaoying@vip.qq.com
Received: August 10, 2022 Peer-review started: August 10, 2022 First decision: October 21, 2022 Revised: October 26, 2022 Accepted: January 9, 2023 Article in press: January 9, 2023 Published online: March 16, 2023
Abstract
BACKGROUND
Endocardial fibroelastosis (EFE) is a diffuse endocardial collagen and elastin hyperplasia disease of unknown etiology, which may be accompanied by myocardial degenerative changes leading to acute or chronic heart failure. However, acute heart failure (AHF) without obvious associated triggers is rare. Prior to the report of endomyocardial biopsy, the diagnosis and treatment of EFE are highly susceptible to being confounded with other primary cardiomyopathies. Here, we report a case of pediatric AHF caused by EFE mimicking dilated cardiomyopathy (DCM), with the aim of providing a valuable reference for clinicians to early identify and diagnose EFE-induced AHF.
CASE SUMMARY
A 13-mo-old female child was admitted to hospital with retching. Chest X-ray demonstrated enhanced texture in both lungs and an enlarged heart shadow. Color doppler echocardiography showed an enlarged left heart with ventricular wall hypokinesis and decreased left heart function. Abdominal color ultrasonography revealed a markedly enlarged liver. Pending the result of the endomyocardial biopsy report, the child was treated with a variety of resuscitative measures including nasal cannula for oxygen, intramuscular sedation with chlorpromazine and promethazine, cedilanid for cardiac contractility enhancement, and diuretic treatment with furosemide. Subsequently, the child’s endomyocardial biopsy report result was confirmed as EFE. After the above early interventions, the child’s condition gradually stabilized and improved. One week later, the child was discharged. During a 9-mo follow-up period, the child took intermittent low-dose oral digoxin with no signs of recurrence or exacerbation of the heart failure.
CONCLUSION
Our report suggests that EFE-induced pediatric AHF may present in children over 1 year of age without any apparent precipitants, and that the associated clinical presentations are grossly similar to that of pediatric DCM. Nonetheless, it is still possible to be diagnosed effectively on the basis of the comprehensive analysis of auxiliary inspection findings before the result of the endomyocardial biopsy is reported.
Core Tip: Prior to the report of endomyocardial biopsy, the diagnosis and treatment of endocardial fibroelastosis (EFE) is highly susceptible to be confounded with other primary cardiomyopathies. Herein, we report a case of pediatric acute heart failure (AHF) caused by EFE mimicking dilated cardiomyopathy, aiming to provide a valuable reference for clinicians to early identify and diagnose EFE-induced AHF.
