Document Detail

Viral myocarditis presenting with seizure and electrocardiographic findings of acute myocardial infarction in a 14-month-old child.
MedLine Citation:
PMID:  10828777     Owner:  NLM     Status:  MEDLINE    
Acute viral myocarditis is an uncommon but potentially fatal illness in children. Patients with myocarditis may present with nonspecific symptoms or atypical findings that make diagnosis in the emergency department difficult. We describe a previously healthy 14-month-old child with difficulty breathing and a tonic-clonic seizure who was subsequently found to have ECG changes and cardiac marker elevation consistent with acute myocardial infarction. The patient was immediately transferred from our community hospital ED to our tertiary care children's hospital. Shortly after admission, the patient developed intractable nonperfusing ventricular arrhythmias necessitating extracorporeal membrane oxygenation. Cardiac function did not recover, and the patient required heart transplantation before cessation of bypass. Serology and anatomic pathology confirmed coxsackievirus B myocarditis. This case illustrates (1) the nonspecific presentation of myocarditis as dyspnea and seizure, (2) the manner in which myocarditis can mimic myocardial infarction, and (3) the importance of early diagnosis in the ED and transfer to a tertiary care facility.
R Cunningham; R Silbergleit
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of emergency medicine     Volume:  35     ISSN:  0196-0644     ISO Abbreviation:  Ann Emerg Med     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-06-26     Completed Date:  2000-06-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  618-22     Citation Subset:  AIM; IM    
Department of Emergency Medicine, University of Michigan, Ann Arbor, 48103, USA.
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MeSH Terms
Cardiopulmonary Resuscitation
Child, Preschool
Coxsackievirus Infections / diagnosis*,  therapy
Diagnosis, Differential
Enterovirus B, Human*
Epilepsy, Tonic-Clonic / diagnosis*,  therapy
Heart Transplantation
Myocardial Infarction / diagnosis*,  therapy
Myocarditis / diagnosis*,  therapy
Shock, Cardiogenic / diagnosis,  therapy

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