Persistent Atrial Standstill in Acute Myocarditis
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Case :

A 10-year-old girl presented with congestive heart failure (CHF) following an episode of low grade fever. She had no family history of cardiac illness, pacemaker implantation, embolic events or skeletal muscle disease. Investigations revealed a normal total leukocyte count (7x 109/L) with 18% neutrophils. Serum electrolytes were in the normal range. The ECG at the time of presentation showed absent P waves and a wide QRS regular escape rhythm at 40/min (Fig. 1). Cardiac troponin T was raised (1793 ng/L). Echocardiogram showed hypokinesia of the left ventricle and mild left ventricular (LV) dysfunction. Her Anti-ds DNA and anti-nuclear antibody titres were normal. She had received intravenous immunoglobulins, ampicillin and ranitidine before she was referred to our unit. We continued conservative management with bed rest, diuretics, and digoxin. Her CHF improved, and subsequently she was discharged. At review visit 6 weeks later, she had no CHF but had the same ventricular escape rhythm and exertional fatigue. Echocardiogram showed improved LV function (ejection fraction 51%). Mitral and tricuspid inflow Doppler study showed absence of "a" wave suggestive of total atrial standstill (Fig. 2). An evaluation done for neuromuscular disease showed normal muscle strength and normal electromyography.........

http://www.indianpediatrics.net/feb2016/feb-162-164.htm
Dr. b●●●●●●●●a j●●●●●t s●●●h and 1 others like this
Like
Comment
Share
Dr. b●●●●●●●●a j●●●●●t s●●●h
Dr. b●●●●●●●●a j●●●●●t s●●●h Cardiology
Rare cases.good writeup.
Apr 30, 2017Like