Abstract
A 13-year-old girl presented with incessant ventricular tachycardia complicating acute Coxsackie B3 myocarditis. Electrophysiologic assessment revealed that the tachycardia could not be terminated, overdrive suppressed or accelerated by programmed electrical stimulation, but was transiently slowed by intravenous adenosine triphosphate and had marked spontaneous and sympathoautonomic-mediated fluctuation in the tachycardia cycle length. These features were atypical of reentry and triggered automaticity and suggested that abnormal automaticity was the likely tachycardia mechanism. Intravenous amiodarone slowed the ventricular tachycardia, but the patient eventually succumbed from rapidly progressive left ventricular failure. Postmortem pathohistologic examination confirmed the diagnosis of acute myocarditis.
MeSH terms
-
Adolescent
-
Atrioventricular Node / physiopathology
-
Bundle of His / physiopathology
-
Cardiac Pacing, Artificial
-
Coxsackievirus Infections / diagnostic imaging
-
Coxsackievirus Infections / pathology
-
Coxsackievirus Infections / physiopathology*
-
Echocardiography
-
Electrocardiography
-
Enterovirus B, Human*
-
Female
-
Heart Failure / diagnostic imaging
-
Heart Failure / pathology
-
Heart Failure / physiopathology
-
Humans
-
Myocarditis / diagnostic imaging
-
Myocarditis / pathology
-
Myocarditis / physiopathology*
-
Myocardium / pathology
-
Tachycardia, Atrioventricular Nodal Reentry / diagnostic imaging
-
Tachycardia, Atrioventricular Nodal Reentry / pathology
-
Tachycardia, Atrioventricular Nodal Reentry / physiopathology
-
Tachycardia, Ventricular / diagnostic imaging
-
Tachycardia, Ventricular / pathology
-
Tachycardia, Ventricular / physiopathology*