My 17 yr son was diagnosed with POTS after complaints of severe symptoms (dizziness, lightheadedness, syncope, faded vision, inability to focus… also extremity cap refills > 5 secs with dependent venous distention).
His 24 hr Holter monitor showed:
Sustained bradycardia in the 40’s while sleeping and severe tachycardia in the 170’s when standing.
He was put on Metoprolol 25mg PO Q AM.
His Echo showed:
Grade 3 LV DD with normal EF.
RV and RA enlargement.
Mitral, tricuspid, and pulmonic valves regurgitation and insufficiency.
We have a follow-up appt with the Cardiologist scheduled in 1 wk from today.
I am a RN (12 yrs now) who has worked in Cardiopulmonary for over a yr. and have never seen – or heard of – a teenager or adolescent with this degree of heart disease, nor am I able to find any references in my research except some vague statements about cardiomyopathy and infection as causes of LV DD. (We can safely rule out the primary causes of HTN and DM.)
Garrett did have a severe case of Salmonella related to sushi that he ate for his 10th birthday and was hospitalized for dehydration and hypokalemia. We never had a retest to check to see if he was free of the bacteria, which I am told now that we should have.
My fear is that the Salmonella infection became systemic and resulted in Myocarditis which has lead to this progression of symptoms over the past 7 yrs.
Anyone know anything at all about LV DD in children?
Or if POTS can result from this degree of LV DD, or if it is a separate condition entirely.
(I am certain that the RV/RA enlargements are due to compensation for the LV dysfunction and that the valve inefficiencies are due to the abnormal compensation mechanisms.)
Any insight at all will be greatly appreciated <3