[Basic information] Female, 10 years old
[Disease type] arrhythmia, premature beats
[Visit time] July 2021
[Treatment hospital] Peking University People’s Hospital
[Treatment Plan: Review echocardiography, exercise more
[Treatment cycle] Long-term
[Treatment result] Recovering
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【Reason for Sharing】If a child has premature beats, parents are generally nervous and anxious, but they do not know how to treat or treat it. Today I will share with you a case of premature beats.
I. Getting to know the patient for the first time
Recently saw a mother whose daughter was 9 years and 10 months old but had arrhythmia. The patient’s mother told me that when she was on a high-speed train, she heard a passenger next to her talk about my experience in treating her son’s frequent premature ventricular contractions. The child did not undergo surgery, nor did he take the coenzyme Q10 and fructose phosphate prescribed by the hospital. Now I have grown up healthy and grown up, and the premature beats have disappeared! Because of this experience, the patient’s mother and her daughter found me.
Looking at the anxious mother with her lovely daughter in her arms, I reassured her and asked her to tell me about her daughter’s past illness. The mother of the child recalled that when her daughter had an electrocardiogram in July 2019, a non-paroxysmal junctional escape rhythm was found with ventricular capture. Blood test for creatine kinase was slightly higher (the specific value is unknown). The local hospital recommends regular review.
In March 2021, arrhythmia, frequent premature ventricular contractions were found in Zhejiang Children’s Insurance, and 24-hour dynamic electrocardiogram showed 9233 premature ventricular contractions and 958 short bursts Tachycardia. So he was diagnosed with arrhythmia and recommended regular review. In July 2021, a blood test in the hospital due to diarrhea showed creatine kinase 47u/L, and the electrocardiogram showed first-degree atrioventricular block and frequent atrial premature beats.
Because of poor treatment effect, she was referred to Ningbo Women’s and Children’s Hospital. A 24-hour dynamic cardiogram showed 39,687 premature ventricular contractions, 2,151 single episodes, and 618 paired episodes. Occurred, 4932 accelerated ventricular escape rhythms, incomplete interfering atrioventricular dissociation. The diagnosis was arrhythmia and diarrhea. During hospitalization, bifidobacteria were given symptomatic treatment and Chinese medicine conditioning, and the patient was discharged after the symptoms improved.
In October 2021, the electrocardiogram was checked at Ningbo Women’s and Children’s Hospital and showed: premature ventricular contractions. Another 24-hour dynamic electrocardiogram showed 64,613 premature ventricular contractions, 8,584 short bursts of ventricular tachycardia, accelerated ventricular escape rhythm, incomplete atrioventricular dissociation T wave changes, sinus arrhythmia, and short burst junctional bradycardia. speed. Arrhythmia was again diagnosed. The doctor gave metoprolol, one tablet in the morning and half a tablet in the evening. It is ineffective for arrhythmia after medication.
ECG examination
The patient’s mother finished talking about her daughter’s past visit to a doctor, and added that she has been taking her daughter around since 2019 to many hospitals. Her biggest worry is that every time the test is different, she wants to know if there is a serious problem with her daughter’s heart? Why is the treatment ineffective? She is very worried about her daughter’s health. Every night when the child falls asleep, she will crawl on her chest and listen to her heartbeat. Every time she hears it, it beats irregularly. The mother’s sleep is getting worse and worse, and she is tired and weak during the day.
My daughter has always been asymptomatic. Going to school during the day is in good spirits, and is no different from other classmates. When my daughter was 7 months old, she suffered from severe diarrhea and began to have restless sleep and dreams in the second half of the night. After falling asleep, she tossed and changed her position, and sometimes screamed and roared loudly in the second half of the night. The mother woke her daughter, who said she had an unhappy dream. Sometimes when you are angry or frightened, or when you are nervous, your heart rate will increase, and it will get better after a while.
The patient’s mother was also a little nervous when she was talking about this passage. I really feel sorry for the parents in the world. I can only comfort the patient, don’t worry if you are sick, and treat it slowly.