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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
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: CSriram@dmc.org

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.

Type
Brief Report
Copyright
© Cambridge University Press 2016 

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