Cardioversor desfibrilador implantável em criança com miocárdio não-compactado isolado

Abstract

CLINICAL DATA9-year-old male child, 25 kg, from Barretos, Sao Paulo.Full-term patient presenting cardiorespiratory arrest (CRA)without defined cause and remained for 30 days in IntensiveCare Unit (ICU). At 11 months presented episode of fainting,followed by cyanosis and CRA. He had undergonecardioversion due to ventricular fibrillation (sic). At thetime, corticoid and digitalis were used, and the patientevolved well until the last two months, when presentednew fainting episode at rest, requiring cardiac massage andnew cardioversion to revert this presentation. Amiodarone,spironolactone, aspirin and suspension of digitalis wereadministered. After about 10 episodes of syncope andfainting, the child was referred to the ICU of our Service.On physical examination the patient was in good generalcondition, afebrile, acyanotic and eupneic. Precordiumunchanged, regular heart rhythm, with normal and rhythmicsounds. Pulmonary auscultation was normal. Flaccidabdomen, liver at 2 cm from the right costal margin, spleennot palpable and presence of bowel sounds. Goodperipheral perfusion, without edema, palpable andsymmetrical pulses in all limbs, without motor sequels withonly mild mental retardation, resulting from the CRA at thetime of parturition (sic).ELECTROCARDIOGRAMSinus rhythm, heart beat of 88 bpm, SÂP 0°, SÂQRS -30°, PR interval 0.24s. First-degree AV block, atrial and leftventricular overload, and left branch block.RADIOGRAMVisceral