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Recurrent Congestive Heart Failure in a Child Due to Probable Myocarditis

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Abstract

Recurrent congestive heart failure (CHF) attributable to myocarditis is a seldom-discussed entity in the scientific literature. This report describes the case of an 8-year-old girl who had three clinically identical episodes of CHF, beginning at the age of 5 years, with each episode preceded by a viral prodrome. The clinical features and the echocardiography and electrocardiogram findings were most supportive of myocarditis. Symptoms and investigations completely normalized between episodes. The third episode, associated with influenza A (strain H1N1) infection, led to cardiac arrest and death on day 2 after admission. Autopsy showed mild cardiomegaly with microscopic foci of myocardial fibrosis and extensive contraction band necrosis. This report is the first to describe recurrent CHF due to probable myocarditis in a pediatric patient.

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Acknowledgments

We thank the family of the patient for providing consent to report this case. We also thank Dr R. Skinner, Regional Supervising Coroner for Eastern Ontario for permission to include the results of the postmortem examination in this report.

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Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, V6T 2B5, Canada

    A. F. Lee

  2. Division of Pathology, The Hospital for Sick Children, Toronto, ON, M5G 1X8, Canada

    D. A. Chiasson

  3. Division of Pediatric Cardiology, Kingston General Hospital, Kingston, ON, K7L 2V7, Canada

    J. F. Smythe

  4. Division of Pediatric Cardiology, British Columbia Children’s Hospital, 4480 Oak Street, Vancouver, BC, V6H 3N1, Canada

    S. Sanatani

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  1. A. F. Lee
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  2. D. A. Chiasson
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  3. J. F. Smythe
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  4. S. Sanatani
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Correspondence to S. Sanatani.

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Lee, A.F., Chiasson, D.A., Smythe, J.F. et al. Recurrent Congestive Heart Failure in a Child Due to Probable Myocarditis. Pediatr Cardiol 33, 176–181 (2012). https://doi.org/10.1007/s00246-011-0109-3

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  • DOI: https://doi.org/10.1007/s00246-011-0109-3

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