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Catecholaminergic polymorphic ventricular tachycardia in a 3-year-old with occult myocarditis.

Randall M Bryant1, Sharon P Redfearn, Don Marangi

  • 1University of Florida Pediatric Cardiovascular Center, Jacksonville 32207, USA. rmbryant@ufl.edu

Pacing and Clinical Electrophysiology : PACE
|November 7, 2002
PubMed
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Occult myocarditis, potentially caused by adenovirus, may trigger catecholaminergic polymorphic ventricular tachycardia (CPVT) in children. This finding offers a new perspective on the etiology of this rare cardiac condition.

Area of Science:

  • Pediatric Cardiology
  • Infectious Disease
  • Electrophysiology

Background:

  • Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare but serious arrhythmia in children.
  • The known causes of CPVT include genetic mutations, but viral infections have not been widely recognized as triggers.
  • Identifying novel etiologies is crucial for accurate diagnosis and effective management of pediatric arrhythmias.

Observation:

  • A 3-year-old female experienced ventricular fibrillation, initially mistaken for a breath-holding spell.
  • Electrophysiological studies ruled out inducible ventricular arrhythmias under baseline conditions.
  • Low-dose epinephrine challenge confirmed catecholaminergic polymorphic ventricular tachycardia (CPVT).

Findings:

  • Endomyocardial biopsies revealed adenoviral DNA in the affected child.

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  • Polymerase chain reaction (PCR) analysis confirmed the presence of viral genetic material.
  • This suggests a link between occult myocarditis and the development of CPVT.

    • Implications:

    • Occult myocarditis should be considered as a potential cause of CPVT in pediatric patients.
    • Viral infections may unmask or trigger CPVT in susceptible children.
    • Further research is warranted to explore the role of viral myocarditis in pediatric arrhythmias and guide treatment strategies.