儿童多系统炎症综合征所致完全性房室传导阻滞：一例报告

Complete atrioventricular block due to multisystem inflammatory syndrome in children: a case report.

作者信息

Rahmadhany Anisa, Sukardi Rubiana, Nursyirwan Sarah Rafika, Djer Mulyadi M

机构信息

Department of Child Health, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.

Center of Integrated Cardiac Service, Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia.

出版信息

Turk J Pediatr. 2022;64(6):1125-1129. doi: 10.24953/turkjped.2022.236.

DOI:10.24953/turkjped.2022.236

PMID:36583895

Abstract

BACKGROUND

Cardiac manifestations in multisystem inflammatory syndrome in children (MIS-C) may involve the conduction system. The incidence and publication is still very limited.

CASE

We report the case of a 2-year-old girl who presented with complete atrioventricular (AV) block with a current infection of SARS-CoV-2 and fulfilled the criteria of MIS-C. After observation for 2 weeks of the SARS-CoV-2 convalescence phase and temporary pacemaker insertion, the complete AV block was not resolved. The intrinsic junctional escape beat was only 40 beats/minute. We decided to implant a dual-chamber epicardial permanent pacemaker to maintain synchrony between atrium and ventricle and furthermore provide hemodynamic stability. We observed persistent complete AV block 9 months after SARS-CoV-2 infection in long-term follow up of this patient.

CONCLUSIONS

Complete AV block in MIS-C could persist months after its onset. Our case could give additional knowledge regarding the natural history of cardiac involvement after SARS-CoV-2 infection.

摘要

背景

儿童多系统炎症综合征（MIS-C）的心脏表现可能累及传导系统。其发病率及相关报道仍然非常有限。

病例

我们报告一例2岁女童，患有完全性房室传导阻滞，同时感染了SARS-CoV-2，符合MIS-C标准。在SARS-CoV-2恢复期观察2周并临时植入起搏器后，完全性房室传导阻滞仍未缓解。固有交界性逸搏心率仅为40次/分钟。我们决定植入双腔心外膜永久起搏器，以维持心房和心室同步，并进一步提供血流动力学稳定性。在该患者的长期随访中，我们观察到SARS-CoV-2感染9个月后仍存在持续性完全性房室传导阻滞。