Diagnostic Dilemma

An 1½ month old with atrial bigemini


Author:
Question
An 1½ month old boy previously asymptomatic presented with sudden onset agitation and breathlessness since morning. There was no history of fever, cough, vomiting or altered sensorium. There was no history of any drug ingestion. Family history was non-contributory. On examination, he had irregular pulse with tachycardia {heart rate = 180, min}. Systemic examination and blood pressure was normal. His ECG shows regularly irregular rhythm with atrial bigemini. His serum CPK was normal though CPK-MB fraction was elevated {20 percent of total CPK}. His SGOT was also elevated. Echocardiography showed normal ejection fraction. Hemogram, serum electrolytes, X-Ray Chest, venous blood gas was normal. He was treated with Amiodarone to which he responded. His urine organic acids and serum Carnitine was normal.

What is the probable diagnosis_?
Expert Opinion :
The authors have replied that they have managed the child as per SVT and he has responded to amiodarone.
Answer Discussion :
S
Sangeethaca
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SVT WITH 2ND DEGREE HEART BLOCK
15 years ago
S
Samira Alfayadh
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myocarditis
15 years ago

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