Dysfonctionnement cardiaque secondaire à un orage adrénergique ou cardiomyopathie de stress chez l’enfant victime d’un traumatisme

Abstract

ObjectiveTo provide information specific to a catecholaminergic storm during a violent stress in children. Patients and methodsTwo clinical observations in children who suffered violent trauma. ResultsFirst case: a boy aged 12 years victim of a drowning in Stage 3 admitted to the pediatric intensive care 02.08.2015. He was intubated, ventilated, sedated with benzodiazepines and morphine. Cardiac exploration revealed a global hypokinesis with septal dyskinesia, a 45% FES offset a slight excess of ST, a troponin I to 31.46pg/mL NT-proBNB to 1291pg/mL. Dobutamine was set initially at 7 then 10 gamma/kg/min. The outcome was favorable on the heart level with improved SEF in 1 week. Second case: 13-year-old girl, victim of complete hanging, admitted on 06/08/2015 for a post-anoxic encephalopathy. Intubated, ventilated and sedated with morphine and benzodiazepines. Cardiac exploration showed septal hypokinesia with a 35% FES, a lengthening of the QT interval on the ECG, a troponin I in ultra 1.27μg/L, NT-proBNB to 215pg/mL. The child was put up 15 gamma dobutamine/kg/min. The evolution was marked by improved heart function without disturbance wall motion after 7 days. ConclusionOur 2 clinical cases following accidental trauma violating represent observations of a picture simulating a syndrome of Tako-Tsubo without anginal pain objectified as our 2 patients were sedated and ultrasound abnormalities returned to normal in less than a week.