Persistent crying in infants: Not always colic [Choro persistente em crian?as: Nem sempre c?licas]

Autores da FMUP

• André Miguel Afonso De Sousa Moreira

  Autor

Participantes de fora da FMUP

• de Bragan?a, RL
• Antunes Sarmento, J.
• Granja, S
• Grilo, M

Unidades de investigação

• Patologia

Abstract

Persistent crying in infants includes a wide range of differential diagnoses, from benign causes to life-threatening situations. Anomalous left coronary artery from pulmonary artery syndrome is a rare congenital heart disease that presents as ischemia or heart failure in the first months of life and prompts urgent surgical treatment. A 5-week-old infant was taken to the emergency department due to inconsolable crying. Physical examination revealed a mitral systolic murmur. Chest X-ray evidenced cardiomegaly. The electrocardiogram and laboratory exams suggested myocardial ischemia. On the echocardiogram, he presented dilated left chambers, left ventricular dysfunction, and mitral regurgitation. An aortography was performed showing uncertain origin of the left coronary artery. A computed tomography angiography confirmed the diagnosis and reimplantation surgery was conducted with a favorable outcome. Although rare, anomalous left coronary artery from pulmonary artery syndrome can result in acute myocardial infarction and sudden death. A high rate of clinical suspicion and a thorough examination are key to diagnosis, treatment, and prognosis. ? Author(s) (or their employer(s)) and Portuguese Journal of Pediatrics 2020.