Reminder of important clinical lesson
Acute fulminant carditis presenting with sustained ventricular tachycardia, and recovery after extracorporeal cardiopulmonary resuscitation
1 Veterans General Hospital Taipei, Department of Pediatrics, Room 534, Nr 201–202, Lane 2, Shih Pei Road, Shih Pei, Taipei, 112, Taiwan, Province of China
2 Veterans General Hospital Taipei, Department of Pediatrics, Shi-Pei Road. Sec. 2. Nr 202–202, Taipei, 112, Taiwan, Province of China
3 Veterans General Hospital Taipei, Department of Cardiovascular Surgery, Shi-Pei Road, Sec. 2, Nr 202–202 Taipei, 112, Taiwan, Province of China
Correspondence to:
jenherlu{at}gmail.com
A 12-year-old boy consulted a local physician with complaints of cough, abdominal pain, shortness of breath and general malaise. Medications for symptomatic relief and bed rest were suggested. The flu-like symptoms were relieved on the 2nd day, and the general malaise with repeated vomiting, chest pain and chest tightness attenuated on the 3rd day. A chest x ray showed multiple pneumonic patches with borderline cardiomegaly. Poor left ventricular function was noted, and the left ventricular ejection fraction was reduced to 21%. Although multiple episodes of sustained ventricular tachycardia were converted by six repeated cardiac defibrillations and a xylocaine (intravenous) bolus infusion, his general condition went downhill to shock and proceeded to several episodes of heart standstill that necessitated cardiopulmonary resuscitation. Extracorporeal cardiopulmonary resuscitation was installed via femoral cannulation. Cardiac function progressively recovered to normal, and extracorporeal membrane oxygenation was removed on the 7th day. The patient completely recovered and was discharged on the 15th day with no neurological sequelae.
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