Ectopic Atrial Tachycardia and Reversible Myocardial Dysfunction in a Child with Enterovirus 71 Infection: A Case Report
Sarin Lekchuensakul¹, Supaluck Kanjanauthai², Apichai Khongphatthanayothin¹,³
Affiliation : ¹ Center of excellence in Arrhythmia Research Chulalongkorn University, Department of Medicine and Division of Pediatric Cardiology, Department of Pediatrics, Chulalongkorn University and Cardiac Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand; ² Division of Pediatric Cardiology, Department of Pediatrics, Siriraj Hospital, Bangkok, Thailand; ³ Bangkok General Hospital, Bangkok, Thailand
The authors reported a rare case of ectopic atrial tachycardia (EAT) with reversible myocardial dysfunction associated with enterovirus 71 (EV71) infection. A previously healthy 11-year-old boy presented with progressive heart failure. An initial ECG revealed a regular narrow QRS tachycardia with abnormal P wave morphology. Echocardiography showed severely impaired left ventricular function (LVEF 20%). Viral study (PCR) in stool was positive for EV71. Treatment with inotropic support, amiodarone, and carvedilol resulted in gradual restoration of sinus rhythm over 10 days. Cardiac function returned to normal within three months. EV71 can cause EAT along with other complications and should be considered in patients with persistent tachycardia and cardiac dysfunction. Recognizing this arrhythmia led to proper management to control ventricular rate, then termination of the tachycardia and gradual restoration of ventricular function to normal.
Received 16 August 2021 | Revised 14 November 2022 | Accepted 2 December 2022
DOI: 10.35755/jmedassocthai.2023.02.13772
Keywords : Enterovirus 71; Ectopic atrial tachycardia; Myocardial dysfunction; Myocarditis; Heart failure
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