Parada cardíaca: presentación mortal de una miocarditis viral / Cardiac arrest: Fatal presentation of viral myocarditis

La miocarditis es un trastorno inflamatorio del miocardio que cursa con la necrosis de los miocitos. La principal causa son las infecciones virales. La presentación clínica es muy variada: desde formas leves hasta formas fulminantes que cursan con la muerte y que se inician frecuentemente con síntomas banales. Presentamos el caso de un niño de 18 meses que acude a urgencias por astenia y anorexia de 24h de evolución, con antecedente de fiebre en el contexto de infección respiratoria de vías altas la semana anterior. A su llegada a urgencias y durante las primeras horas de observación la exploración física fue rigurosamente normal. Posteriormente presentó empeoramiento progresivo del estado general (palidez y mala perfusión periférica) con alteraciones analíticas (acidosis metabólica, insuficiencia renal e hiperglucemia) y de forma brusca parada cardiorrespiratoria sin respuesta a maniobras de reanimación cardiopulmonar (AU)

Myocarditis is an inflammatory disease of the myocardium accompanied by necrosis of myocytes. The main causes are viral infections. The clinical presentation varies from mild forms to devastating ones which usually begin with trivial symptoms with progression, in some cases, to death. We report the case of an 18 month-old male toddler consulting for asthenia and anorexia for the last 24h and a previous history of respiratory tract infection with high fever in the last week. Upon arrival at the emergency room and during the first hours of admission, physical examination was perfectly normal. Later, his general state gradually deteriorated, with biochemical disturbances (metabolic acidosis, renal failure and hyperglycaemia) and, eventually, a sudden cardiac arrest, with no response to cardiopulmonary resuscitation manoeuvres (AU)

[Cardiac arrest: fatal presentation of viral myocarditis]. / Parada cardíaca: presentación mortal de una miocarditis viral.

Myocarditis is an inflammatory disease of the myocardium accompanied by necrosis of myocytes. The main causes are viral infections. The clinical presentation varies from mild forms to devastating ones which usually begin with trivial symptoms with progression, in some cases, to death. We report the case of an 18 month-old male toddler consulting for asthenia and anorexia for the last 24h and a previous history of respiratory tract infection with high fever in the last week. Upon arrival at the emergency room and during the first hours of admission, physical examination was perfectly normal. Later, his general state gradually deteriorated,with biochemical disturbances (metabolic acidosis, renal failure and hyperglycaemia) and, eventually, a sudden cardiac arrest, with no response to cardiopulmonary resuscitation manoeuvres.