Prolonged COVID-19 Induced Cardiac Threat in Children, Giant Coronary Aneurysms Linked to MIS-C Can Persist for Years!
Nikhil Prasad Fact checked by:Thailand Medical News Team May 04, 2025 5 hours, 19 minutes ago
Medical News: A new case report from researchers at Koşuyolu High Specialization Training and Research Hospital in Istanbul, Türkiye, reveals concerning findings about long-term heart complications in children diagnosed with multisystem inflammatory syndrome in children (MIS-C), a condition that surfaced during the COVID-19 pandemic. Contrary to earlier assumptions that heart issues in MIS-C patients typically resolve within weeks, the case detailed in this
Medical News report shows that giant coronary artery aneurysms can persist even years after initial diagnosis and treatment.
Prolonged COVID-19 Induced Cardiac Threat in Children, Giant Coronary Aneurysms Linked to MIS-C Can Persist for Years
The study tracked a 4-year-old boy who developed multiple giant aneurysms in his coronary arteries after being diagnosed with MIS-C following exposure to the SARS-CoV-2 virus. The child presented with persistent fever and gastrointestinal symptoms and had significantly elevated inflammatory markers. Despite rapid clinical improvement following intensive treatment that included intravenous immunoglobulin (IVIG), corticosteroids, aspirin, and blood thinners like enoxaparin and warfarin, advanced cardiac imaging revealed persistent and large aneurysms in the coronary arteries even 30 months later.
The Case That Defied Expectations
Initially healthy, the young boy was admitted to the hospital with 13 days of fever, mild abdominal pain, and diarrhea. Lab tests revealed extremely high inflammatory markers, including C-reactive protein (CRP), D-dimer, interleukin-6, and cardiac enzymes. These markers, along with a recent family history of COVID-19 infection and abnormal echocardiographic findings, confirmed the diagnosis of MIS-C.
Transthoracic echocardiography detected two large aneurysms in the left anterior descending (LAD) artery and dilations in other key coronary arteries. Following treatment, symptoms rapidly subsided and inflammatory levels dropped.
However, an 8-week follow-up coronary angiogram showed that the aneurysms had not resolved and were significantly larger than initially estimated.
To prevent blood clots and other complications from the aneurysms, the child was placed on a long-term regimen of low-dose aspirin and warfarin. Even with stable clinical condition and no outward symptoms, periodic echocardiograms and two rounds of catheter-based angiography confirmed that the aneurysms continued to persist at alarming sizes.
Why This Matters
MIS-C has often been compared to Kawasaki Disease, another pediatric condition that causes inflammation in blood vessels. However, this case adds to growing evidence that MIS-C might have more severe and long-lasting cardiovascular effects. Researchers noted that the coronary aneurysms in this case decreased only slightly over 30 months, underscoring the importance of long-term cardiac surveillance and extended anticoagulation therapy in such patients.
The study also raised concerns about
misdiagnosis or delayed diagnosis, especially in cases where Kawasaki-like symptoms appear during or after a COVID-19 infection. MIS-C differs from Kawasaki Disease in patient age distribution, lab markers, and prevalence of gastrointestinal symptoms. In this case, distinguishing features such as high troponin and NT-proBNP levels, combined with systemic inflammation, pointed toward MIS-C rather than classical Kawasaki Disease.
Looking Ahead
The medical team emphasized that this case challenges assumptions that MIS-C-related coronary issues are always short-lived. Even in the absence of symptoms, children with large coronary artery aneurysms following MIS-C require consistent and extended cardiac monitoring, including catheter angiography where needed. They also need long-term use of antiplatelet and anticoagulant drugs to prevent life-threatening complications such as heart attacks or blood clots.
Importantly, the coronary dimensions in this patient decreased only minimally even after two and a half years, suggesting that the arterial damage from the initial hyperinflammatory response might be irreversible in some cases. These findings support a more cautious and extended approach to managing MIS-C in children with severe coronary involvement.
The study findings were published in the peer reviewed journal: Frontiers in Pediatrics.
https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2025.1549321/full
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Medical News.
Read Also:
https://www.thailandmedical.news/news/uncovering-the-role-of-gut-permeability-in-mis-c-a-new-insight-into-pediatric-covid-19-complications
https://www.thailandmedical.news/news/children-face-long-term-gastrointestinal-issues-after-covid-19-infection
https://www.thailandmedical.news/news/kidney-issues-emerging-in-children-after-mild-covid-19-infections-raises-new-concerns
https://www.thailandmedical.news/articles/coronavirus
https://www.thailandmedical.news/pages/thailand_doctors_listings
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