Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2022; 10(13): 4214-4219
Published online May 6, 2022. doi: 10.12998/wjcc.v10.i13.4214
Extensive myocardial calcification in critically ill patients receiving extracorporeal membrane oxygenation: A case report
Ming-Liang Sui, Chang-Jiang Wu, Ya-Di Yang, Da-Mei Xia, Tian-Jie Xu, Wei-Bing Tang
Ming-Liang Sui, Chang-Jiang Wu, Ya-Di Yang, Da-Mei Xia, Tian-Jie Xu, Wei-Bing Tang, Department ofCritical Care Medicine, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine, Suzhou 215028, Jiangsu Province, China
Author contributions: Sui ML designed the study, performed the literature review, drafted the manuscript, formulated the data table and reviewed the manuscript; Tang WB performed the literature review, supervision, writing-review and editing; Wu CJ contributed to the data curation, investigation, and writing-original draft; Yang YD and Xu TJ performed the literature review and suggested pertinent modification; Xia DM performed data analysis, reviewed the manuscript; and All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors have nothing to disclose for this manuscript.
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: Ming-Liang Sui, MD, Chief Doctor, Department of Critical Care Medicine, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine, Industrial Park, Suzhou 215028, Jiangsu Province, China. sml13451648826@163.com
Received: September 11, 2021
Peer-review started: September 11, 2021
First decision: October 25, 2021
Revised: November 3, 2021
Accepted: March 15, 2022
Article in press: March 15, 2022
Published online: May 6, 2022
Abstract
BACKGROUND

Myocardial calcification is a rare complication in critically ill patients. The prognosis of myocardial calcifications in critically ill patients is very poor if not treated in a timely manner. We describe a rare case of acute extensive myocardial calcifications due to acute myocarditis after receiving extracorporeal membrane oxygenation (ECMO) support.

CASE SUMMARY

We report a 17-year-old male patient who developed extensive myocardial calcifications while receiving prolonged ECMO support for severe myocarditis and cardiogenic shock. Extensive myocardial calcifications were confirmed by chest computed tomography (CT). Myocardial calcifications were observed in the left ventricle walls on CT examination 10 days after admission. The patient was then discharged with heart function class II on the NYHA classification. Two years later, the patient was still alive with adequate quality of life. We then included this patient and 7 other cases retrieved from the PubMed, Cochrane Library, EMBASE, and MEDLINE databases in our study, in order to provide a reference for the clinical diagnosis and treatment of this disease.

CONCLUSION

Multiple causes including prolonged hemodynamic failure, profound acidosis, high vasopressor doses, and acute renal failure may jointly lead to extensive myocardial calcifications. The precise role of ECMO support in the timing and frequency of acute myocardial calcifications deserves further investigation.

Keywords: Cardiogenic shock, Cardiac calcification, Extracorporeal membrane oxygenation, Case report

Core Tip: We report a 17-year-old male patient who developed extensive myocardial calcifications while receiving prolonged extracorporeal membrane oxygenation(ECMO) support for severe myocarditis and cardiogenic shock. Extensive myocardial calcifications were confirmed by chest computed tomography. The precise role of ECMO support in the timing and frequency of acute myocardial calcifications deserves further investigation.