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Junctional tachycardia in a child with non-rheumatic fever streptococcal pharyngitis

Published online by Cambridge University Press:  19 December 2016

Neha Bansal ,
Peter P. Karpawich  and
Chenni S. Sriram
Neha Bansal
Affiliation:
The Carmen and Ann Adams Department of Pediatrics, Division of Cardiology, The Children’s Hospital of Michigan, School of Medicine, Wayne State University, Detroit, Michigan, United States of America
Peter P. Karpawich
Affiliation:
The Carmen and Ann Adams Department of Pediatrics, Division of Cardiology, The Children’s Hospital of Michigan, School of Medicine, Wayne State University, Detroit, Michigan, United States of America
Chenni S. Sriram*
Affiliation:
The Carmen and Ann Adams Department of Pediatrics, Division of Cardiology, The Children’s Hospital of Michigan, School of Medicine, Wayne State University, Detroit, Michigan, United States of America
*
Correspondence to: C. S. Sriram, MD, Division of Pediatric Cardiology, The Children’s Hospital of Michigan, 3901 Beaubien Boulevard, Detroit, MI 48201, United States of America. Tel: 313 745 5481; Fax: 13 993 0894; E-mail: [email protected]
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Abstract

Accelerated junctional rhythm has been reported in children in the setting of acute rheumatic fever; however, we describe a hitherto unreported case of isolated junctional tachycardia in a child with streptococcal pharyngitis, not meeting revised Jones criteria for rheumatic fever. A previously healthy, 9-year-old girl presented to the emergency department with complaints of sore throat, low-grade fever, and intermittent chest pain. She was found to have a positive rapid streptococcal antigen test. The initial electrocardiogram showed junctional tachycardia with atrioventricular dissociation in addition to prolonged and aberrant atrioventricular conduction. An echocardiogram revealed normal cardiac anatomy with normal biventricular function. The patient responded to treatment with amoxicillin for streptococcal pharyngitis. The junctional tachycardia and other electrocardiogram abnormalities resolved during follow-up.

Keywords

Junctional tachycardiastreptococcal pharyngitisarrhythmia
Type
Brief Report
Information
Cardiology in the Young , Volume 27 , Issue 5 , July 2017 , pp. 985 - 989
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Copyright
© Cambridge University Press 2016 

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References

1. Garson, A Jr, Gillette, PC. Junctional ectopic tachycardia in children: electrocardiography, electrophysiology and pharmacologic response. Am J Cardiol 1979; 44: 298–302.Google Scholar
2. Amrousy, DE, Elshehaby, W, Feky, WE, Elshmaa, NS. Safety and efficacy of prophylactic amiodarone in preventing early junctional ectopic tachycardia (JET) in children after cardiac surgery and determination of its risk factor. Pediatr Cardiol 2016; 37: 734–739.Google Scholar
3. Zampi, JD, Hirsch, JC, Gurney, JG, et al. Junctional ectopic tachycardia after infant heart surgery: incidence and outcomes. Pediatr Cardiol 2012; 33: 1362–1369.Google Scholar
4. Makhoul, M, Oster, M, Fischbach, P, Das, S, Deshpande, S. Junctional ectopic tachycardia after congenital heart surgery in the current surgical era. Pediatr Cardiol 2013; 34: 370–374.CrossRefGoogle ScholarPubMed
5. Sarubbi, B, Musto, B, Ducceschi, V, et al. Congenital junctional ectopic tachycardia in children and adolescents: a 20 year experience based study. Heart 2002; 88: 188–190.Google Scholar
6. Collins, KK, Van Hare, GF, Kertesz, NJ, et al. Pediatric nonpost-operative junctional ectopic tachycardia medical management and interventional therapies. J Am Coll Cardiol 2009; 53: 690–697.CrossRefGoogle ScholarPubMed
7. Clarke, M, Keith, JD. Atrioventricular conduction in acute rheumatic fever. Br Heart J 1972; 34: 472–479.Google Scholar
8. Cristal, N, Stern, J, Gueron, M. Atrioventricular dissociation in acute rheumatic fever. Br Heart J 1971; 33: 12–15.CrossRefGoogle ScholarPubMed
9. Karacan, M, Isikay, 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.CrossRefGoogle ScholarPubMed
10. Ceviz, N, Celik, V, Olgun, H, Karacan, M. Accelerated junctional rhythm in children with acute rheumatic fever: is it specific to the disease? Cardiol Young 2014; 24: 464–468.Google Scholar
11. 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.Google Scholar
12. Caraco, J, Arnon, R, Raz, I. Atrioventricular block complicating acute streptococcal tonsillitis. Br Heart J 1988; 59: 389–390.Google Scholar
13. Ward, DE. Unusual capture phenomena during interaction of dissociated sinus and junctional rhythms: spontaneous expression of intranodal duality and gap phenomenon. J Electrocardiol 1982; 15: 299–306.Google Scholar
14. Rosenberg, DH. Acute myocarditis in mumps (epidemic parotitis). Arch Intern Med 1945; 76: 257–263.Google Scholar
15. Rantz, LA, Spink, WW, Boisvert, PJ. Abnormalities in the electrocardiogram following hemolytic streptococcus sore throat. Arch Intern Med 1946; 77: 66–79.CrossRefGoogle ScholarPubMed
16. Bang, O. Gonorrhoeal myocarditis. BMJ 1940; 1: 117–120.Google Scholar
17. Izumi, Y, Yonesaka, S, Saito, A. Electrocardiographic and electrophysiological studies on arrhythmias following streptococcal infection in school children. Japanese Circ J 1980; 44: 814–816.Google Scholar
18. Sanyal, SK, Thapar, MK, Sharma, DB, Shrivastava, OP. Atrioventricular conduction in children with acute rheumatic fever. Am J Dis Child 1976; 130: 473–476.Google Scholar
19. Sriram, CS, White, RD, Madhavan, M, Cannon, BC. Isolated junctional tachycardia in a child after noncardiac surgery: an uncommon clinical presentation. Pediatr Cardiol 2011; 32: 1234–1237.Google Scholar
20. Frank, DB, Patel, AR, Sanchez, GR, Shah, MJ, Bonney, WJ. Junctional tachycardia in a child with Lyme carditis. Pediatr Cardiol 2011; 32: 689–691.Google Scholar
21. Maiers, JA, Ebenroth, ES. Junctional ectopic tachycardia following complete heart block associated with viral myocarditis. Pediatr Cardiol 2006; 27: 367–368.Google Scholar
22. Karjalainen, J. Streptococcal tonsillitis and acute nonrheumatic myopericarditis. Chest 1989; 95: 359–363.Google Scholar
23. Putterman, C, Caraco, Y, Shalit, M. Acute nonrheumatic perimyocarditis complicating streptococcal tonsillitis. Cardiology 1991; 78: 156–160.Google Scholar
24. Said, SA, Severin, WP. Acute nonrheumatic myopericarditis associated with group A hemolytic streptococcal tonsillitis in a male ICU-nurse. Neth J Med 1998; 53: 266–270.Google Scholar
25. Kirmser, R, Umbach, R, Rowett, D, Ross, A. Complete heart block due to acute nonspecific carditis. Chest 1977; 71: 682–684.CrossRefGoogle ScholarPubMed