vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v24i1.2863vsp-3682Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL OBSERVATIONSТечение синдрома удлиненного интервала QT на фоне новой коронавирусной инфекции. Клинический случайLong QT Syndrome Course Associated with New Coronavirus Infection. Clinical Casehttps://orcid.org/0009-0003-6155-9094ИсрафиловаС. Х.IsrafilovaSabina Kh.

Исрафилова Сабина Хилал кызы, аспирант кафедры детских болезней им. проф. И.М. Воронцова; заведующая отделением функциональной диагностики 

192289, Санкт-Петербург, ул. Бухарестская, д. 134, 

тел.: +7 (812) 400-04-10

Saint Petersburg

sab201794@mail.ruhttps://orcid.org/0000-0002-6865-0136КручинаТ. К.KruchinaTatiana K.

Санкт-Петербург

Saint Petersburg

https://orcid.org/0000-0001-7035-0100ЖдановаМ. В.ZhdanovaMarina V.

Санкт-Петербург

Saint Petersburg

https://orcid.org/0000-0003-2277-1183КлименкоЛ. О.KlimenkoLada О.

Санкт-Петербург

Saint Petersburg

https://orcid.org/0000-0002-7571-5460НовикГ. А.GennadiyNovik A.

Санкт-Петербург

Saint Petersburg

ДГКБ № 5 им. Н.Ф. Филатова; СПбГПМУРоссияChildren’s City Hospital №5 named after N.F. Filatov; Saint Petersburg State Pediatric Medical UniversityRussian FederationСПбГПМУРоссияSaint Petersburg State Pediatric Medical UniversityRussian Federation20252502202524119–25Copyright © Исрафилова С.Х., Кручина Т.К., Жданова М.В., Клименко Л.О., Новик Г.А., 20252025Исрафилова С.Х., Кручина Т.К., Жданова М.В., Клименко Л.О., Новик Г.А.Israfilova S.K., Kruchina T.K., Zhdanova M.V., Klimenko L.О., Gennadiy N.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/3682Обоснование

Обоснование. Синдром удлиненного интервала QT — наследственное заболевание, разновидность сердечных каналопатий, которое характеризуется обмороками и высоким риском внезапной сердечной смерти в результате возникновения полиморфной желудочковой тахикардии (ЖТ) типа «пируэт» и фибрилляции желудочков. Острая респираторная вирусная инфекция может ухудшать клиническое течение первичных электрических заболеваний сердца.

Описание клинического случая. Пациентка, 14 лет, в ноябре 2021 г. поступила в инфекционный стационар переводом из другого стационара с положительным ПЦР-тестом на новую коронавирусную инфекцию (COVID-19) после эпизода потери сознания. Впервые обмороки были отмечены в 12 лет, но потом не рецидивировали, а в связи с пандемией COVID-19 обследование и лечение были отложены. Синкопальные состояния возобновились на фоне COVID-19. Было проведено кардиологическое обследование в инфекционном стационаре, диагностирована рецидивирующая ЖТ по типу «пируэт» на фоне удлинения интервала QT. После проведенного лечения и подбора антиаритмической терапии состояние девочки улучшилось, через 15 дней получен отрицательный ПЦР-тест на SARS-CoV-2, и пациентка была переведена в профильный стационар, где был подтвержден синдром удлиненного интервала QT и был имплантирован двухкамерный кардиовертер-дефибриллятор.

Заключение

Заключение. Клинический случай демонстрирует, что ОРВИ может привести к ухудшению клинического течения имеющихся первичных аритмий и подчеркивает важность своевременной диагностики и комплексного подхода к лечению пациентов с генетически обусловленными нарушениями ритма сердца.

Background

Background. Long QT syndrome is hereditary disease, cardiac canalopathy variant, characterized by syncope and high risk of sudden cardiac death due to occurrence of polymorphic ventricular tachycardia (VT), torsade de pointes, and ventricular fibrillation. Acute respiratory viral infection may aggravate clinical course of primary electrical heart diseases.

Clinical case description. 14-year-old female patient was transferred to infectious diseases hospital from another hospital with positive PCR test on new coronavirus infection (COVID-19) after loss of consciousness in November 2021. Syncope was first noted at the age of 12, however then did not recur, and their examination and treatment were postponed due to the COVID-19 pandemic. Syncopal states continued during COVID-19. Cardiac examination was performed at infectious diseases hospital: recurrent VT, torsade de pointes, was diagnosed along with QT interval prolongation. The girl's condition has improved after the treatment and selection of antiarrhythmic therapy. 15 days later negative PCR test for SARS-CoV-2 was received, and the patient was transferred to specialized hospital, where the long QT syndrome was confirmed, and dual-chamber cardioverter defibrillator was installed.

Conclusion

Conclusion. This clinical case demonstrates that ARVI can aggravate the course of existing primary arrhythmia and emphasizes the crucial role of timely diagnosis and integrated approach to the management of patients with genetically determined cardiac arrhythmias.

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The authors declare that there are no conflicts of interest present.