A Life-Threatening Cardiac Arrhythmia: Pediatric Myocarditis

Abstract

Cardiac arrhythmias results from disturbance of electrical impulse formation and conduction. Supraventricular tachycardia is the most common emergent paediatric arrhythmias, with an incidence of 1 in 250 to 1000 children. Symptoms may vary from mild chest pain, to congestive cardiac failure. A 7-year-old male with no underlying comorbidities presented to the emergency department with sudden onset dyspnoea and chest pain. Upon examination he was tachypnoeic, normotensive and afebrile. The electrocardiogram revealed a narrow complex regular tachycardia with a rate of 250 bpm. The child was in cardiac failure. He did not respond to pharmacological cardioversion. Due to respiratory distress and haemodynamic instability, he was electrically cardioverted.  However, his condition deteriorated and he developed pulseless electrical activity. Following two cycles of cardiopulmonary resuscitation, return of spontaneous circulation was achieved, and he was admitted to the paediatric intensive care unit. Blood serology was tested positive for Mycoplasma Pneumoniae, and he was treated as Mycoplasma myocarditis. He went on to make an uneventful recovery and was discharged six days later.