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Cardiac involvement in postnatal rubella
B D Thanopoulos1, S Rokas, C A Frimas
1Paediatric Cardiovascular Laboratory, Nikea General Hospital, Piraeus, Greece.
Insights
Rubella infection can cause serious heart problems like myocarditis and heart failure in children. While one boy recovered with a pacemaker, another experienced severe heart failure, highlighting potential long-term risks.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Viral Myocarditis
Background:
- Rubella, a viral illness, is typically mild but can lead to severe complications.
- Myocarditis, inflammation of the heart muscle, can affect children following viral infections.
Observation:
- Two pediatric cases of rubella-induced myocarditis are presented.
- Case 1: A 6-year-old boy developed complete atrioventricular block on day 3 of rubella.
- Case 2: A 12-year-old boy developed myocarditis with congestive heart failure 20 days post-rubella.
Findings:
- The first patient required permanent pacing but achieved normal growth and activity within six years.
- The second patient experienced significant deterioration, presenting with severe heart failure six months after infection.
- These cases illustrate the potential for significant cardiac morbidity following postnatal rubella.
Implications:
- Rubella myocarditis can manifest with conduction abnormalities or congestive heart failure.
- Outcomes for rubella myocarditis vary, ranging from full recovery to severe, progressive heart failure.
- Awareness of these cardiac complications is crucial for managing children with rubella.
Abstract:
Two cases of rubella myocarditis are reported: a 6-year-old boy who developed a complete, distal to His, atrioventricular block, during the third day of illness; and a 12-year-old boy who developed myocarditis with congestive heart failure 20 days following rubella infection. Although permanent pacing was required in the first patient, six years later he showed a normal growth and maintained normal activity. The second patient has deteriorated markedly and 6 months after the initial illness he had severe heart failure. It should be noted that myocarditis with abnormalities of the conduction system or congestive heart failure may be a complication to postnatal rubella.