Supraventricular Tachycardia in a Child with Varicella Myocarditis
A 9 year-old boy was admitted to the hospital with stomachache, vomiting and rash. Tachypnea, tachycardia, hypotension, gallop rhythm, and typical skin eruption of varicella were noted on the physical examination. An electrocardiogram showed ST depression and supraventricular tachycardia. Echocardiography revealed slight enlargement of the left ventricle with normal ejection fraction, but no valve regurgitation or pericardial effusion. Varicella zoster virus serum immunoglobulin M antibody was positive. The arrhythmia resolved with digoxin. He was discharged home without sequela.
1- Grote V, von Kries R, Springer W, Hammersen G, Kreth HW, Liese J. Varicella- related deaths in children and adolescents-Germany 2003-2004. Acta Paediatr. 2008; 97: 187-92. 2- Abrams D, EA, Redington DJ, Shinebourne
complications in children following infection with varicella zoster virus. Cardiol Young. 2011; 11: 647-52. AN.
Cardiac 3- Dinleyici EC, Kurugol Z, Turel O, et al. The epidemiology and economic impact of varicella- related hospitalizations in Turkey from 2008 to 2010: a nationwide survey during the pre-vaccine era (VARICOMP study). Eur J Pediatr. 2012; 171: 817-25.
4- Kao KL, Yeh SJ, Chen CC. Myopericarditis associated with varicella zoster virus infection. Pediatr Cardiol. 2010; 31: 703-6.
5- Rich R, McErlean M. Complete heart block in a child with varicella. Am J Emerg Med. 1993; 11: 602-5.
6- Magnani JW, Dec GW. Myocarditis: current trends in diagnosis and treatment. Circulation. 2006; 113: 876-90.
7- O'Grady MJ, Moylett E. Cardiac-related varicella mortality in childhood: a literature review with clinical experience. Pediatr Cardiol. 2011; 32: 1241-3.
8- Woolf PK, Chung TS, Stewart J, Lialios M, Davidian
dysrhythmias in varicella myocarditis. Clin Pediatr (Phila). 1987; 26: 480-2. MH.
Life-threatening 9- Lorber A, Zonis Z, Maisuls E, Dembo L, Palant A, Iancu TC. The scale of myocardial involvement in varicella myocarditis. Int J Cardiol. 1988; 20: 257-62. 10
Dennison P, Zaremba E. Varicella zoster induced cardiac dysfunction: a case report. Emerg Med J. 2007; 24: 682-3.