Electrocardiograph Abnormalities in Children With Lyme Meningitis
Elizabeth J Welsh1, Keri A Cohn2, Lise E Nigrovic3
1Department of Pediatrics, and Divisions of.
Journal of the Pediatric Infectious Diseases Society
|December 1, 2015
Summary
Electrocardiographic (ECG) abnormalities are common in children with Lyme meningitis, affecting one-third of patients. Older age and prolonged fever increase the risk of these changes.
Area of Science:
- Pediatric infectious diseases
- Cardiology
- Epidemiology
Background:
- Lyme meningitis is a serious infection in children.
- Electrocardiographic (ECG) changes can occur in early-disseminated Lyme infection.
- The prevalence and risk factors for ECG changes in pediatric Lyme meningitis are not well-established.
Purpose of the Study:
- To estimate the prevalence of ECG abnormalities in children diagnosed with Lyme meningitis.
- To identify risk factors associated with ECG changes in this pediatric population.
Main Methods:
- Cross-sectional study conducted in three urban pediatric tertiary care centers.
- Included children diagnosed with Lyme meningitis who underwent ECG testing.
- Multivariable logistic regression analysis used to identify independent risk factors for ECG abnormalities.
Main Results:
- ECG abnormalities were present in 33% of 103 children with Lyme meningitis.
- Common abnormalities included atrioventricular block (16%), ST-T wave changes (14%), and prolonged QT interval (11%).
- Independent risk factors for ECG abnormalities were age ≥13 years and fever lasting ≥5 days.
Conclusions:
- Electrocardiographic abnormalities are frequent in pediatric Lyme meningitis.
- Older children (≥13 years) with prolonged fever (≥5 days) have the highest likelihood of ECG abnormalities.
- The clinical significance of asymptomatic ECG changes in pediatric Lyme meningitis requires further investigation.
Related Concept Videos
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
947
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
947
01:27Myocarditis II: Clinical Features and Diagnostic Tests
445
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
445
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
1.0K
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
1.0K
01:29Disturbances in Heart Rhythm
3.6K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
3.6K
01:29Electrocardiogram
7.8K
An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
7.8K
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
810
Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
810