Sadece palpitasyon ile kendini gösteren romatizmal kardit

Yıl 2023, Cilt: 16 Sayı: 3, 506 - 509, 01.07.2023

Eyüp Aslan Cem Karadeniz

https://doi.org/10.31362/patd.1248280

Öz

Akut Romatizmal Ateş (ARF) ciddi bir halk sağlığı sorunu olmaya devam etmektedir ve gelişmekte olan ülkelerde yaygındır. Atriyoventriküler düğüm blokları, erken atımlar, hızlanmış nodal ritim, ventriküler taşikardi ve Torsades de pointes gibi aritmiler hastalığın erken evrelerinde görülebilir.
Romatizmal karditin tek semptomunun çarpıntı olduğu bir dar QRS taşikardisi olgusunu sunuyoruz. Asetilsalisilik asit tedavisi ile hastalık inaktif hale geldikten sonra taşikardi normal sinüs ritmine döndü.

Anahtar Kelimeler

Çocuk, romatizmal kardit, taşikardi

Rheumatic carditis presented with only palpitation

Öz

Acute Rheumatic Fever (ARF) remains a serious public health problem and is common in the developing countries. Arrhythmias such as atrioventricular nodal blocks, premature beats, accelerated nodal rhythm, ventricular tachycardia and Torsades de pointes can be seen in the early stages of the disease.
We present a case of narrow QRS tachycardia in which palpitation was the only symptom of rheumatic carditis. After the disease became inactive with acetylsalicylic acid treatment, the tachycardia returned to normal sinus rhythm.

Anahtar Kelimeler

Child, rheumatic carditis, tachycardia

Kaynakça

• 1. Carano N, Bo I, Tchana B, Vecchione E, Fantoni S, Agnetti A. Adams-Stokes attack as the first symptom of acute rheumatic fever: report of an adolescent case and review of the literature. Ital J Pediatr 2012;38:61. https://doi.org/10.1186/1824-7288-38-61
• 2. Balli S, Oflaz MB, Kibar AE, Ece I. Rhythm and conduction analysis of patients with acute rheumatic fever. Pediatr Cardiol 2013;34:383-389. https://doi.org/10.1007/s00246-012-0467-5
• 3. Ramoğlu MG, Epçaçan S, Yeşilbaş O. Acute rheumatic fever presenting with severe endocarditis involving four valves, and ventricular tachycardia. Cardiol Young 2019;29:78-81. https://doi.org/10.1017/S1047951118001518
• 4. Liberman L, Hordof AJ, Alfayyadh M, Salafia CM, Pass RH. Torsade de pointes in a child with acute rheumatic fever. J Pediatr 2001;138:280-282. https://doi.org/10.1067/mpd.2001.110302
• 5. Gewitz MH, Baltimore RS, Tani LY, et al. Revision of the Jones Criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography: a scientific statement from the American Heart Association. Circulation 2015;131:1806-1818. https://doi.org/10.1161/CIR.0000000000000205
• 6. Sokolow M. Significance of electrocardiographic changes in rheumatic fever. Am J Med 1948;5:365-378. https://doi.org/10.1016/0002-9343(48)90087-4
• 7. Umapathy S, Saxena A. Acute rheumatic fever presenting as complete heart block: report of an adolescent case and review of literature. BMJ Case Rep 2018;2018: bcr2017223792. https://doi.org/10.1136/bcr-2017-223792
• 8. Karacan M, Işıkay S, Olgun H, Ceviz N. Asymptomatic rhythm and conduction abnormalities in children with acute rheumatic fever: 24-hour electrocardiography study. Cardiol Young 2010;20:620-630. https://doi.org/10.1017/S104795111000079X
• 9. Narula J, Chopra P, Talwar KK, et al. Does endomyocardial biopsy aid in the diagnosis of active rheumatic carditis? Circulation 1993;88:2198-2205. https://doi.org/10.1161/01.cir.88.5.2198
• 10. Oran B, Coban H, Karaaslan S, Atabek E, Gürbilek M, Erkul I. Serum cardiac troponin-I in active rheumatic carditis. Indian J Pediatr 2001;68:943-944. https://doi.org/10.1007/BF02722592
• 11. Polat TB, Yalcin Y, Akdeniz C, Zeybek C, Erdem A, Celebi A. QT dispersion in acute rheumatic fever. Cardiol Young 2006;16:141-146. https://doi.org/10.1017/S1047951106000060
• 12. Kucuk M, Karadeniz C, Ozdemir R, Meşe T. Evaluation of ventricular arrhythmogenesis in children with acute rheumatic carditis. Cardiovasc J Afr 2018;29:362-365. https://doi.org/10.5830/CVJA-2018-043