{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T21:58:06Z","timestamp":1747173486128,"version":"3.40.5"},"reference-count":9,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T00:00:00Z","timestamp":1616371200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>SARS-CoV-2, which causes the disease COVID-19, generally has a mild disease course in children. However, a severe post-infectious inflammatory process known as multisystem inflammatory syndrome in children has been observed in association with COVID-19. This inflammatory process is a result of an abnormal immune response with similar clinical features to Kawasaki disease. It is well established that multisystem inflammatory syndrome in children is associated with myocardial dysfunction, coronary artery dilation or aneurysms, and occasionally arrhythmias. The most common electrocardiographic abnormalities seen include premature atrial or ventricular ectopy, variable degrees of atrioventricular block, and QTc prolongation, and rarely, haemodynamically significant arrhythmias necessitating extracorporeal membrane oxygenation support. However, presentation with fever, hypotension, and relative bradycardia with a left axis idioventricular rhythm has not been previously reported. We present a case of a young adolescent with multisystem inflammatory syndrome in children with myocarditis and a profoundly inappropriate sinus node response to shock with complete resolution following intravenous immunoglobulin.<\/jats:p>","DOI":"10.1017\/s1047951121000354","type":"journal-article","created":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T06:02:05Z","timestamp":1616392925000},"page":"1202-1204","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":6,"title":["COVID-19-associated multisystem inflammatory syndrome in children presenting uniquely with sinus node dysfunction in the setting of shock"],"prefix":"10.1017","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8335-8363","authenticated-orcid":false,"given":"Lesya G.","family":"Tomlinson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitchell I.","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca E.","family":"Levorson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan B.","family":"Tzeng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2021,3,22]]},"reference":[{"key":"S1047951121000354_ref7","first-page":"1","article-title":"Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV2","author":"Whittaker","year":"2020","journal-title":"JAMA - J Am Med Assoc"},{"key":"S1047951121000354_ref4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2021680"},{"key":"S1047951121000354_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31094-1"},{"key":"S1047951121000354_ref9","article-title":"Acute heart failure in multisystem inflammatory syndrome in children (MIS-C) in the context of global SARS-CoV-2 pandemic","volume":"33","author":"Belhadjer","year":"2020","journal-title":"Circulation"},{"key":"S1047951121000354_ref2","doi-asserted-by":"publisher","DOI":"10.1002\/art.41454"},{"key":"S1047951121000354_ref3","unstructured":"3. Son, MB , Friedman, K . Coronavirus disease 2019 (COVID-19): Multisystem inflammatory syndrome in children. In: Fulton, D , Kaplan, S , Sundel, R , Randolph, A , Armsby, C , TePas, E (eds). UpToDate, 2020. Available from https:\/\/www.uptodate.com\/contents\/coronavirus-disease-2019-covid-19-multisysteminflammatory-syndrome-in-children?search=MISc&source=search_result&selectedTitle=1~55&usage_type=default&display_rank=1"},{"key":"S1047951121000354_ref8","first-page":"1","article-title":"Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study","author":"Toubiana","year":"2020","journal-title":"Br Med J"},{"key":"S1047951121000354_ref5","first-page":"1","article-title":"COVID-19\u2013Associated pediatric multisystem inflammatory syndrome","author":"Deza Leon","year":"2020","journal-title":"J Pediatric Infect Dis Soc"},{"key":"S1047951121000354_ref6","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.048360"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951121000354","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T10:49:32Z","timestamp":1646304572000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951121000354\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,22]]},"references-count":9,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["S1047951121000354"],"URL":"https:\/\/doi.org\/10.1017\/s1047951121000354","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"type":"print","value":"1047-9511"},{"type":"electronic","value":"1467-1107"}],"subject":[],"published":{"date-parts":[[2021,3,22]]},"assertion":[{"value":"\u00a9 The Author(s), 2021. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}