Sudden Death in a Child: The Mystery Behind the Cardiac Mass ED08-ED10
Dr. Neethu Tony Mampilly,
CRRA-9, 37/3292, Cherupilly Road, Kaloor, Cochin-682017, Kerala, India.
A 12-year-old boy suddenly collapsed while playing and was brought to the emergency department, where he was declared dead. The child had no prior medical illness. On autopsy examination, a dumbbell shaped mass was found in the right atrioventricular sulcus on the anterior and posterior aspects. Microscopic examination of the mass revealed a thrombus within the wall of right coronary artery. Careful examination of the epicardial tissue close to the thrombus revealed a granulomatous vasculitis of the right coronary artery, with involvement of the root of aorta. A possible diagnosis of Takayasu’s arteritis was rendered. Vasculitis is the inflammation of the blood vessels. Kawasaki’s and Takayasu’s arteritis are the most common ones affecting the vessels of the heart. Takayasu’s arteritis or “pulseless” disease is a rare, idiopathic, chronic granulomatous vasculitis that affects aorta and its major branches. The rarity of its occurrence and clinical presentation as a thrombus masquerading as cardiac tumour is unusual and hence reported.