Fujita Shuhei, Futatani Takeshi, Kubo Tatsuya, Itamochi Masae, Yachi Yusuke, Iwasaki Hidenori, Shimao Ayako, Ina Shihomi, Higashiyama Hiroyuki, Igarashi Noboru, Hatasaki Kiyoshi
Department of Pediatrics, Toyama Prefectural Central Hospital, Toyama, Japan.
Department of Virology, Toyama Institute of Health, Toyama, Japan.
Pediatr Int. 2017 May;59(5):627-632. doi: 10.1111/ped.13261. Epub 2017 Apr 12.
Herein we describe the case of a 1-month-old boy with acute viral myocarditis, who presented with two kinds of paroxysmal supraventricular tachycardia, and who was cured after medical treatment. He was brought to the emergency room with poor feeding due to fever. On the third day of hospitalization, a narrow QRS tachycardia (180-200 beats/min) was detected. Echocardiography showed a high echoic area at the atrial septum around the atrioventricular node. The patient was clinically diagnosed with acute myocarditis. The narrow QRS tachycardia was diagnosed as incessant junctional ectopic tachycardia. The patient was treated with propranolol and landiolol. The frequency of the tachycardia decreased, but a different narrow QRS tachycardia was detected on the 15th day of hospitalization on electrocardiogram (220 beats/min), which was ascribed to atrioventricular nodal re-entrant tachycardia. Atenolol was effective for the tachycardia. At 2 years follow up, cardiac function was normal and tachycardia had not recurred.
在此，我们描述了一名1个月大患急性病毒性心肌炎的男婴病例，该患儿出现两种阵发性室上性心动过速，经药物治疗后痊愈。他因发热喂养困难被送至急诊室。住院第三天，检测到窄QRS心动过速（180 - 200次/分钟）。超声心动图显示房室结周围房间隔有高回声区。该患者临床诊断为急性心肌炎。窄QRS心动过速被诊断为持续性交界性异位性心动过速。患者接受了普萘洛尔和兰地洛尔治疗。心动过速频率降低，但在住院第15天心电图检测到另一种不同的窄QRS心动过速（220次/分钟），这归因于房室结折返性心动过速。阿替洛尔对该心动过速有效。随访2年时，心脏功能正常且心动过速未复发。
