{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:34:46Z","timestamp":1768005286132,"version":"3.49.0"},"reference-count":9,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T00:00:00Z","timestamp":1623369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Hypothyroidism can lead to bradycardia, reduced cardiac output, cardiac enlargement, and abnormal electrocardiogram. However, hemodynamic instability and malignant arrhythmias due to hypothyroidism is rarely reported in children.<\/jats:p><jats:p><jats:bold>Patient Findings:<\/jats:bold> We report the case of a child with third-degree atrioventricular block, cardiogenic shock, and Adams Stokes Syndrome, who was initially misdiagnosed with fulminant myocarditis and was later found to have hypothyroidism during treatment.<\/jats:p><jats:p><jats:bold>Summary:<\/jats:bold> The child's condition did not improve after the administration of gamma globulin, methylprednisolone, and isoproterenol. Even after the placement of temporary pacemakers, the therapeutic effect was still not ideal. Upon reviewing the medical history, the child's condition improved rapidly after levothyroxine supplementation.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Hypothyroidism is a common disease, but secondary severe cardiovascular lesions are particularly rare in children. Therefore, the delay in diagnosis can lead to serious cardiovascular manifestations. When pediatric patients develop severe AVB and bradycardia, hypothyroidism should be considered as a possible cause.<\/jats:p>","DOI":"10.3389\/fcvm.2021.698089","type":"journal-article","created":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T16:13:55Z","timestamp":1623428035000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Case Report: Hypothyroidism Misdiagnosed as Fulminant Myocarditis in a Child"],"prefix":"10.3389","volume":"8","author":[{"given":"Nanjun","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuran","family":"Shao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Yan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yimin","family":"Hua","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaiyu","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,6,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e2555","DOI":"10.7759\/cureus.2555","article-title":"A pacemaker that was avoided","volume":"10","author":"Waseem","year":"2018","journal-title":"Cureus"},{"key":"B2","doi-asserted-by":"publisher","first-page":"239","DOI":"10.4021\/cr221w","article-title":"Complete atrioventricular block presenting with syncope caused by severe hypothyroidism","volume":"3","author":"Seol","year":"2012","journal-title":"Cardiol Res"},{"key":"B3","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1007\/BF03086119","article-title":"Hypothyroidism as the cause of atrioventricular block in an elderly patient","volume":"16","author":"Schoenmakers","year":"2008","journal-title":"Neth Heart J"},{"key":"B4","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1111\/j.1540-8159.2006.00284.x","article-title":"A case of transient 2:1 atrioventricular block, resolved by thyroxine supplementation for subclinical hypothyroidism","volume":"29","author":"Nakayama","year":"2006","journal-title":"Pacing Clin Electrophysiol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1378\/chest.63.4.582","article-title":"Reversible atrioventricular block in myxedema","volume":"63","author":"Singh","year":"1973","journal-title":"Chest"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e69","DOI":"10.1161\/CIR.0000000000000745","article-title":"Recognition and initial management of fulminant myocarditis: a scientific statement from the American heart association","volume":"141","author":"Kociol","year":"2020","journal-title":"Circulation"},{"key":"B7","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1056\/NEJM200102153440707","article-title":"Thyroid hormone and the cardiovascular system","volume":"344","author":"Klein","year":"2001","journal-title":"N Engl J Med"},{"key":"B8","first-page":"431","article-title":"Complete atrioventricular heart block in congenital hypothyroidism","volume":"40","author":"Olgunt\u00fcrk","year":"1998","journal-title":"Turk J Pediatr"},{"key":"B9","doi-asserted-by":"publisher","first-page":"151","DOI":"10.4103\/0972-5229.102086","article-title":"Refractory cardiogenic shock in an infant with congenital hypothyroidism","volume":"16","author":"Zaki","year":"2012","journal-title":"Indian J Crit Care Med"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.698089\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T16:13:57Z","timestamp":1623428037000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.698089\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,11]]},"references-count":9,"alternative-id":["10.3389\/fcvm.2021.698089"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2021.698089","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,11]]},"article-number":"698089"}}