Ventricular tachycardia in acute fulminant myocarditis: medical management and follow-up.
The combination of ventricular tachycardia (VT) and severe left ventricular dysfunction presents a serious challenge in management of acute fulminant myocarditis (AFM). We report a case of a 17-month-old girl with AFM, presented with hypotension and VT, successfully treated with respiratory and inotropic support, high-dose intravenous immunoglobulin, and amiodarone. The myocardial function improved significantly within 2 weeks of treatment. The clinical course was complicated by significant amiodarone-induced hepatotoxicity, disseminated intravascular coagulation, and deep-vein thrombosis. She was later diagnosed with congenital dysfibrinogenemia and treated with chronic Lovenox therapy.
Sharma
J R
JR
Division of Pediatric Cardiology, Hematology and Intensive Care, Department of Pediatrics, The Children's Hospital at Downstate/State University of New York, 450, Clarkson Avenue, Brooklyn, NY 11203, USA. jsharma@jhmc.org
Sathanandam
S
S
Rao
S P
SP
Acharya
S
S
Flood
V
V
D000208:Acute Disease; D000638:Amiodarone / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D007223:Infant; D009205:Myocarditis / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D017180:Tachycardia, Ventricular / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D016277:Ventricular Function, Left / Q000187:drug effects
D000806:Angiotensin-Converting Enzyme Inhibitors; D000889:Anti-Arrhythmia Agents; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D004656:Enalapril; D000638:Amiodarone