Case report: fatal ventricular tachycardia exacerbated by fever in a child

Area of Science:

• Pediatric Cardiology
• Electrophysiology
• Pathology

Background:

• Primary ventricular tachycardia (VT) is an uncommon cardiac arrhythmia in pediatric populations.
• Understanding the triggers and pathological basis of pediatric VT is crucial for effective management.

Observation:

• A case of a child experiencing recurrent VT from 5 months of age is presented.
• VT episodes were consistently exacerbated by fever, leading to syncope and frequent hospitalizations.
• Antiarrhythmic drug efficacy was limited during febrile episodes, while antipyretic treatment provided relief.

Findings:

• The patient suffered from recurrent VT, ultimately proving fatal at 17 years of age during a febrile episode.
• Autopsy revealed significant pathological findings: severe fatty replacement of the bundle of His and interstitial fibrosis of the sinus node.

Implications:

• This case underscores the critical link between fever and VT exacerbation in susceptible children.
• The pathological findings suggest a potential substrate for VT in the cardiac conduction system.
• Further research into fever-induced arrhythmias in pediatric VT is warranted to improve clinical outcomes.