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Case Reports in Pediatrics
Volume 2013, Article ID 736164, 5 pages
http://dx.doi.org/10.1155/2013/736164
Case Report

Just Sinus Bradycardia or Something More Serious?

1University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, USA
2Division of Cardiology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, H6/5 Clinical Science Center, 600 Highland Avenue, Madison, WI, USA
3Division of Pediatric Cardiology, Department of Cardiology, Dean Clinic, 700 S. Park Street, Madison, WI 53715, USA

Received 30 June 2012; Accepted 15 October 2012

Academic Editors: M. Docx and L. W. Lim

Copyright © 2013 Kelly R. Egan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

An asymptomatic 5-year-old girl presented with bradycardia during a routine well-child visit. Further evaluation revealed profound sinus bradycardia, exercise-induced bidirectional ventricular tachycardia, and supraventricular tachycardia. An echocardiogram showed heavy trabeculations in the left ventricular myocardium. This patient’s presentation suggested catecholaminergic polymorphic ventricular tachycardia and left ventricular noncompaction. Genetic testing revealed mutations in the cardiac ryanodine receptor (RyR2), calsequestron (CASQ2), and titin (TTN). She was effectively treated with beta-blockade to suppress tachyarrhythmias and pacemaker implantation to treat her bradycardia.