肠病毒71型感染患儿异位房性心动过速和可逆性心肌功能障碍1例报告

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引用次数: 1

摘要

作者报告了一例罕见的异位房性心动过速(EAT)合并可逆心肌功能障碍与肠病毒71 (EV71)感染相关的病例。先前健康的11岁男孩出现进行性心力衰竭。初步心电图显示有规律的窄性QRS心动过速伴异常P波形态。超声心动图显示左心室功能严重受损(LVEF 20%)。粪便病毒PCR检测结果为EV71阳性。在肌力支持、胺碘酮和卡维地洛的治疗下,窦性心律在10天内逐渐恢复。心功能在三个月内恢复正常。EV71可引起EAT和其他并发症,在持续性心动过速和心功能障碍患者中应予以考虑。认识到这种心律失常导致适当的管理,以控制心室率,然后终止心动过速和逐渐恢复心室功能正常。关键词:肠病毒71型;异位房性心动过速;心肌功能障碍;心肌炎;心脏衰竭
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Ectopic Atrial Tachycardia and Reversible Myocardial Dysfunction in a Child with Enterovirus 71 Infection: A Case Report
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. Keywords: Enterovirus 71; Ectopic atrial tachycardia; Myocardial dysfunction; Myocarditis; Heart failure
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