[II-JCKAP2-5] 2 cases of Rapid Progression of heart failure due to severe acute Aortic Insufficiency Caused by aortitis in young age.
Keywords:Aortitis, Aortic Insufficiency, Aortic valve replacement
[Introduction] Severe acute aortic insufficiency is quite rare condition among children and young adolescent without congenital heart disease. We report two cases who experienced rapid progression of heart failure. [Case.1] 13 years old male. He complained severe shortness of breath. There was a history of low-grade fever, diarrhea, and loss of body weight for 2 months prior to admission. Chest X-ray showed significant cardiomegaly and pulmonary edema. Echocardiography revealed enlargement of the left ventricle with decreased ejection fraction of 46% and severe aortic insufficiency. Aortic valve replacement was seemed to be crucial. Bentall operation was needed due to inflammatory dilation of the ascending Aorta and Valsalva sinus. Even though anti-inflammatory therapy was administrated after the operation, he experienced diastasis and dissection of aortic wall, and died when he was 16 years old. [Case.2] 9 years old male. He had vomit and general fatigue and introduced to out institution due to significant cardiomegaly and slightly reduced ejection fraction (54%) of the left ventricle. Echocardiography revealed severe aortic insufficiency with prolapse of LCC and significant dilation of Valsalva sinus. Aortic valve replacement was done, and anti-inflammatory therapy was administrated after the operation. [Discussion] Aortitis may cause acute aortic insufficiency due to valvulitis and dilation of Valsalva sinus and can be catastrophic. Even though it is uncommon among adolescent and children, Aortitis must be regarded in the case of severe acute aortic insufficiency.