Neonatal Med.  2021 May;28(2):77-82. 10.5385/nm.2021.28.2.77.

A Neonate Diagnosed with Wolff-Parkinson-White Syndrome Presenting with Cardiogenic Shock

• Ha JE
• Lee SH
• Park GY
• Shin YL
• Kim SS
• Jang MA

• KMID: 2516489
• DOI: http://doi.org/10.5385/nm.2021.28.2.77

Abstract

We present the case of a healthy 28-day-old female full-term neonate who was admitted to the neonatal intensive care unit for severe metabolic acidosis, hypoglycemia, and an initial sinus rhythm. The first diagnostic hypothesis was hypovolemic shock, and fluid resuscitation was started immediately. During fluid therapy, cardiovascular collapse occurred with supraventricular tachycardia. The latter was successfully treated with adenosine and beta-blockers. After 8 days, electrocardiography showed ventricular pre-excitation, and Wolff-Parkinson-White syndrome was diagnosed. A novel variant of the MYL2 gene that is related to hypertrophic cardiomyopathy and conduction defect was found after discharge. Cardiogenic shock should be considered, despite being a rare cause of shock in neonates.

Keyword

Shock, cardiogenic; Cardiomyopathy, hypertrophic; Acidosis; Tachycardia, supraventricular; Wolff-Parkinson-White syndrome

Figure

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  Figure 1. Chest radiograph of a 28-day-old female with cardiovascular collapse shows mild cardiomegaly (cardiothoracic ratio 56%) without pulmonary edema.

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  Figure 2. (A) Electrocardiography tracing of a 28-day-old female with cardiovascular collapse. Electrocardiography after the first episode of supraventricular tachycardia shows normal sinus rhythm (heart rate of 150 beats per minute). (B) Electrocardiography after the second episode of supraventricular tachycardia shows a short PR interval and wide QRS complex in all leads. This indicates ventricular pre-excitation (delta wave) resulting in the diagnosis of Wolff-Parkinson-White syndrome.

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