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Published on: April 29, 2013
Electrocardiographic Changes in Children with Multisystem Inflammation Associated with COVID-19: Associated with
William Regan1, Laura O'Byrne1, Kirsty Stewart1
1Department of Pediatric Cardiology, Evelina London Children's Hospital, London, United Kingdom.
Insights
Multisystem inflammatory syndrome in children (MIS-C) often shows electrocardiogram (ECG) changes, including low QRS amplitudes and T-wave inversion. These ECG findings typically resolve over time.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a serious condition linked to COVID-19.
- Electrocardiograms (ECGs) are crucial for assessing cardiac involvement in pediatric illnesses.
Purpose of the Study:
- To analyze serial ECG findings in children with MIS-C.
- To identify trends in ECG parameters during illness and follow-up.
Main Methods:
- Retrospective analysis of ECGs from children diagnosed with MIS-C.
- Measurement of ECG intervals (PR, QRSd, QTc) and amplitudes (R, S, T waves).
- Documentation of arrhythmias and ST-segment changes.
Main Results:
- 67% of children with MIS-C exhibited ECG changes.
- Common findings included low QRS amplitudes and transient T-wave inversion.
- ST changes and arrhythmias were infrequent, mostly benign.
Conclusions:
- MIS-C is associated with characteristic serial ECG changes.
- Low amplitude ECGs and T-wave inversion are notable findings.
- Cardiac involvement in MIS-C generally shows favorable ECG recovery.
Objective:
To analyze findings and trends on serial electrocardiograms (ECGs) in multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease taken during the course of illness and at follow-up.
Study Design:
We included all children presenting with MIS-C at a single center with 3 or more ECGs taken during the course of their illness. We measured ECG intervals (PR, QRSd, and QTc) and amplitudes (R-, S-, and T-waves) on each ECG and documented any arrhythmias and ST-segment changes.
Results:
A majority of children (n = 42, 67%) showed ECG changes. The most common findings were low QRS amplitudes and transient T-wave inversion. ST changes were uncommon and included ST-segment elevation consistent with pericarditis in 1 child and acute coronary ischemia in 1 child. Arrhythmias were seen in 13 children (21%) but were benign with the exception of 1 child who was compromised by an atrial tachycardia requiring support with extracorporeal membrane oxygenation. No children were found to have high-grade atrioventricular block.
Conclusions:
MIS-C is associated with electrocardiographic changes over the course of the illness, with low amplitude ECGs on presentation, followed by transient T-wave inversion, particularly in the precordial leads. There was a low prevalence of ST-segment changes and tachyarrhythmias.
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