Sinus bradycardia as the initial manifestation of multisystem inflammatory syndrome in children
European Heart Journal
; 42(SUPPL 1):412, 2021.
Article
in English
| EMBASE | ID: covidwho-1554134
ABSTRACT
Background:
While cardiovascular complications, including arrhythmias are now a recognized manifestation of Multisystem inflammatory syndrome in children (MIS-C), there are no reports of primary bradycardia preceding the clinical presentation. We sought to describe a case series of sinus bradycardia as an initial manifestation of MIS-C.Methods:
We included a series of 10 consecutive patients with confirmed COVID-19 who met WHO and CDC criteria for MIS-C, who developed sinus bradycardia with a heart rate measured in the awake state that was below the normal range for age for children, as an initial manifestation of the disease, in a prospective observational multicenter study. Patients underwent clinical, laboratory evaluation, ECG, Holter, telemetry, echocardiogram, chest X Ray, and a chest CT scan.Results:
Of the 10 patients included, 6 were male, with a mean age of 6.52±5.35 years, range 4 months to 14 years. All cases were Hispanic. Bradycardia was transient and did not merit treatment. Coronary abnormalities were noted in 6 cases;4 patients had mild coronary ectasia;9 patients had pericardial effusion with no evidence of tamponade. All patients had a mild clinical course;none had shock, heart failure, the need for mechanical ventilation, or died. All blood markers (Troponin, BNP, Platelet count, C-reactive protein, D-dimer, Ferritin) returned to normal levels by discharge/follow-up with a favorable outcome including resolution of coronary dilatation in all but 2 in which aneurysm persisted. Treatment All patients received steroids and low-weight-molecular heparin 10 patients, 8 aspirin and 8 intravenous immunoglobulins.Conclusion:
Sinus bradycardia may be the initial manifestation of MIS-C, usually transient and mild. Physicians should be aware of this presentation. (Figure Presented).
acetylsalicylic, acid; C, reactive, protein; D, dimer; endogenous, compound; ferritin; heparin; immunoglobulin; steroid; troponin; adolescent; aneurysm; artificial, ventilation; body, weight; case, report; case, study; child; clinical, article; clinical, evaluation; clinical, laboratory; conference,; coronary, artery, dilatation; drug, therapy; echocardiography; female; ferritin, blood, level; follow, up; heart, failure; Hispanic; human; lesions, and, defects; male; multicenter, study; pediatric, multisystem, inflammatory, syndrome; pericardial, effusion; physician; platelet, count; preschool, child; prospective, study; sinus, bradycardia; telemetry; thorax, radiography; wakefulness; x-ray, computed, tomography
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
European Heart Journal
Year:
2021
Document Type:
Article
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