Montobbio Carolina, Conte Alessio, Calandrino Andrea, Pepe Alessia, Vinci Francesco, Siboldi Alessandra, Formigari Roberto, Ramenghi Luca Antonio
Neonatal Intensive Care Unit, Department of Maternal and Neonatal Health, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy.
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Mother and Child Health, School of Medical and Pharmaceuticals, University of Genoa, 16132 Genoa, Italy.
J Cardiovasc Dev Dis. 2025 Jun 14;12(6):228. doi: 10.3390/jcdd12060228.
Enterovirus (EV) infections in neonates can be transmitted vertically or horizontally, with symptoms ranging from mild to severe, including myocarditis, meningoencephalitis, and hepatitis. Neonates with EV-induced myocarditis may present severe cardiovascular disease with sudden onset of arrhythmia. Neonatal arrhythmias, particularly in low birth weight or critically ill infants, can impair cardiac function and worsen outcomes. EV targets cardiomyocyte receptors, inducing apoptosis pathways and triggering cardiac conduction disturbances. We present an extremely low-birth-weight preterm infant (GW 27 + 6) who developed EV-induced myocarditis, complicated with a sudden onset of supraventricular tachycardia (SVT), pericardial effusion and bi-atrial enlargement. Despite multi-agent regimen, including propranolol, flecainide, and amiodarone, the infant showed persistent junctional rhythm until seven months of age, later transitioning to atrial rhythm with stable cardiac function. A review of previously published rhythm disturbances due to EV-induced myocarditis is presented. Newborns with EV-induced arrhythmia may require a multi-modal treatment such as a multi-agent medical regimen or, in severe non-responsive cases, an electrophysiological approach. EV infections may cause long-term cardiovascular comorbidities (such as left ventricular dysfunction or mitral valve regurgitation), necessitating continuous monitoring through echocardiography and ECG. Collaboration between neonatologists and pediatric cardiologists is crucial for effective treatment and follow-up.
新生儿肠道病毒（EV）感染可通过垂直或水平传播，症状从轻度到重度不等，包括心肌炎、脑膜脑炎和肝炎。患有EV诱导的心肌炎的新生儿可能会出现严重的心血管疾病，并突然出现心律失常。新生儿心律失常，特别是低出生体重或重症婴儿的心律失常，会损害心脏功能并使预后恶化。EV靶向心肌细胞受体，诱导凋亡途径并引发心脏传导障碍。我们报告了一名极低出生体重的早产儿（孕27 + 6周），他患上了EV诱导的心肌炎，并伴有室上性心动过速（SVT）突然发作、心包积液和双房扩大。尽管采用了包括普萘洛尔、氟卡尼和胺碘酮在内的多药联合治疗方案，但该婴儿在7个月大之前一直表现为持续性交界性心律，后来转变为心房心律，心脏功能稳定。本文对先前发表的因EV诱导的心肌炎导致的节律紊乱进行了综述。患有EV诱导的心律失常的新生儿可能需要多模式治疗，如多药联合治疗方案，或者在严重无反应的情况下采用电生理方法。EV感染可能会导致长期心血管合并症（如左心室功能障碍或二尖瓣反流），因此需要通过超声心动图和心电图进行持续监测。新生儿科医生和儿科心脏病专家之间的合作对于有效治疗和随访至关重要。
