Faculty Bibliography

We report a case of a 17-year-old healthy male presenting with multisystem hyperinflammatory shock temporally associated with COVID-19. Cardiac involvement was suspected based on evidence of significant cardiac injury (elevated cardiac biomarkers, electrocardiographic and echocardiographic abnormalities). Cardiac magnetic resonance imaging was performed demonstrating global biventricular systolic dysfunction, as well as a small area of T2 hyperintensity and mid-wall late gadolinium enhancement. This case discusses the varied cardiac involvement in pediatric patients with COVID-19 infection and highlights that cardiac injury is not just limited to hyperinflammatory syndrome related global dysfunction but a more focal myocarditis can also be seen.

We present a case of a 34-day-old baby boy with congestive heart failure and differential cyanosis. Based on echocardiography and confirmed with computed tomography angiography, the following abnormalities were detected: aortopulmonary window, aortic origin of the right pulmonary artery, patent ductus arteriosus, and hypoplasia/coarctation of the aorta. No other congenital abnormalities were detected, and a diagnosis of Berry Syndrome type 2B was made. No preoperative cardiac catheterization or angiocardiography was needed. The patient underwent complete surgical repair of the aortopulmonary window and reconstruction of the hypoplastic aortic arch. This case highlights the value of cross-sectional imaging with computed tomography angiography in the evaluation of complex congenital heart disease

BACKGROUND: Shone's complex is a series of four obstructive or potentially obstructive left-sided cardiac lesions (supravalvular mitral ring, parachute deformity of the mitral value, subaortic stenosis, and coarctation of the aorta). Both the complete form (all four lesions) and incomplete forms (less than four lesions) have been described. OBJECTIVE: To determine which abnormalities of Shone's complex could be characterized by MR. MATERIALS AND METHODS: MR examinations in three patients (one complete, two incomplete) were retrospectively reviewed. RESULTS: A supravalvular mitral ring, found at surgery in one patient, was not identified. Regurgitant and stenotic flow across the mitral valve, abnormal motion of the valve leaflets and abnormalities of the papillary muscles were identified. Individual chordal attachments were difficult to resolve. Narrowing in the subaortic region and abnormal flow from the subaortic region through the valve plane were demonstrated. A discrete subaortic diaphragm in one patient was not resolved. Both focal and diffuse types of coarctation of the aorta were well characterized. CONCLUSION: MR imaging is suited to evaluation of patients with Shone's complex. Individual chordal attachments and thin diaphragms of the mitral and aortic valves were difficult to resolve