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Secondary cardiomyopathy due to incessant supraventricular tachycardia in a child
Author(s) -
Hishitani Takashi,
Ogawa Kiyoshi,
Hoshino Kenji
Publication year - 2004
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.2004.01911.x
Subject(s) - medicine , center (category theory) , supraventricular tachycardia , pediatrics , cardiology , family medicine , tachycardia , chemistry , crystallography
A 3-year-old girl, in whom tachycardia had been noted since 2 years of age without apparent preceding viral infection, was transferred to Saitama Children’s Medical Center, Saitama, Japan, under a diagnosis of dilated cardiomyopathy and tachycardia by a local physician. The chest X-ray showed cardiomegaly (cardiothoracic ratio, 68%; Fig. 1), and echocardiography showed left ventricular dysfunction (LVEF, 40%; Fig. 2). Incessant supraventricular tachycardia with a maximal rate of 220 b.p.m. was observed on electrocardiogram (ECG) (Fig. 3). The P wave was visible in all leads, and a narrow P wave with a higher rate was observed after sinus wave in lead II (Fig. 3). Acute myocarditis was not suspected because there was no abnormal T wave inversion or low voltage in ECG, and an abnormally high serum CK level was not observed. Adenosine triphosphate disodium infusion was not successful, and conventional antiarrhythmic drugs were not effective. The arrhythmia was finally controlled with amiodarone, propranolol and digoxin, and the cardiomegaly and left ventricular dysfunction disappeared within a month. The arrhythmia was diagnosed as ectopic atrial tachycardia in electrophysiologic testing and the child underwent successful catheter ablation.