Background Myocarditis refers to the inflammation of the myocardium caused by infection or autoimmune disease that may or may not present with clinical manifestations, such as gastrointestinal symptoms, dyspnea, chest pain, or sudden death. Although myocarditis and coronary artery vasospasm may mimic ST-segment elevation myocardial infarction (STEMI) with normal coronary arteries on angiography, acute myocarditis rarely causes coronary artery spasm. Here, we report a case of coronary artery spasm with reversible electrocardiographic changes mimicking STEMI in an adolescent with acute myocarditis. Case presentation A 15-year-old boy present with sudden-onset repeated chest pain following a 3-day history of flu-like illness. Cardiac biomarkers were significantly elevated. Electrocardiography showed ST-segment elevation in the absence of detectable vasospasm on coronary angiography. These findings were consistent with the diagnosis of coronary artery spasm secondary to acute myocarditis. Treatment with immunoglobulin for 2 days improved his condition. The patient was discharged on the 12th day with complete resolution of symptoms and normalization of electrocardiogram findings. Conclusions We reported a case of coronary artery spasm due to acute myocarditis. This study highlights the importance of considering coronary artery spasm due to acute myocarditis as a differential diagnosis in patients presenting with signs of STEMI as these diseases have different medical management strategies.
Background: The importance of breastfeeding is well known. One of important factors affecting breastfeeding is socioeconomic status. We investigated the relationship between socioeconomic status and breastfeeding to promote future breastfeeding projects.Methods: Data were collected from the 2013 - 2017 Korea National Health and Nutrition Examination Survey (KNHANES). We evaluated the demographic information and parents’ socioeconomic status of 814 children, aged 12 ~ 60months.Results: Of the 814 children, 743 (92.2%) were breastfed. In univariate analysis, parents’ age and education level were related to breastfeeding (P < 0.05). In logistic regression analysis, mothers’ education level (≤ 13 years: odd ratio[OR], 8.57; 95% confidence interval [CI], 2.73-26.87), mothers’ income level (third quartile: OR, 2.94; 95% CI, 1.2-7.23), fathers’ age (20s: OR, 0.3; 95% CI, 0.09-0.98), fathers’ education level (10-12years: OR 4.85; 95% CI, 1.4-16.76 and 13years: OR, 18.55; 95% CI, 5.23-65.81), fathers’ income (third quartile: OR, 2.72; 95% CI 1.02-7.22) were associated with breastfeeding (P < 0.05).Conclusion: Higher parental income and education level and fathers’ age were positively associated with breastfeeding in Korea. The establishment of future breastfeeding projects should be considered target parents in Korea and other countries.
Vertebral, anal, cardiac, tracheo-esophageal fistula, renal and limb (VACTERL) association is defined as a condition including at least three of the above-mentioned anomalies in the same infant. Several cardiac defects that have been reported as a part of the VACTERL association are ventricular and atrial septal defects, hypoplastic left heart syndrome, transposition of the great arteries and tetralogy of Fallot. Anomalous origin of pulmonary artery (AOPA) from the ascending aorta is an unusual and critical cardiovascular anomaly, which frequently involves the right pulmonary artery (RPA). A male neonate was delivered by normal spontaneous vaginal delivery at 39 weeks and 3 days gestation, weighting 2660 gm. He was diagnosed with VACTERL association with five abnormalities: vertebral abnormalities, anal atresia, cardiovascular anomaly (right pulmonary artery originating from ascending aorta), tracheo-esophageal fistula and renal anomalies. AOPA origination from ascending aorta as part of the VACTERL association in a neonate is a rare congenital cardiovascular malformation. Here we present a rare case of RPA originating from the ascending aorta seen with VACTERL association in a neonate.
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