Fetal dilated cardiomyopathy caused by persistent junctional reciprocating tachycardia.
Ultrasound examination of a fetus at 32 weeks' gestation revealed dilated cardiomyopathy and a heart rate of 170 beats per minute. Prenatally, this mild tachycardia was not primarily suspected to be the cause of the myocardial changes. Postnatal electrocardiography revealed a persistent junctional reciprocating tachycardia (PJRT) and the diagnosis of tachycardia-induced cardiomyopathy (TICM) became apparent. After conversion to a sinus rhythm under digoxin and amiodarone, the cardiac changes regressed. PJRT is a rare form of supraventricular tachycardia. The prenatal findings in the condition have previously been described retrospectively, but it can only be diagnosed postnatally by its characteristic electrocardiographic properties. This case indicates that TICM can occur at lower heart rates than previously assumed. Even severe prenatal cardiomyopathy may be reversible once sinus rhythm has been restored.
Cornette
J
J
Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, Rotterdam, The Netherlands. j.cornette@erasmusmc.nl
ten Harkel
A D J
AD
Steegers
E A P
EA
D000328:Adult; D000638:Amiodarone / Q000008:administration & dosage; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage; D001783:Blood Flow Velocity / Q000502:physiology; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging / Q000209:etiology*; D004077:Digoxin / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging; D005865:Gestational Age; D006340:Heart Rate, Fetal / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D054139:Tachycardia, Reciprocating / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D016216:Ultrasonography, Prenatal
D000889:Anti-Arrhythmia Agents; D004077:Digoxin; D000638:Amiodarone