Supraventricular tachycardia | Pediatric Oncall Journal

IMAGES IN CLINICAL PRACTICE

Supraventricular tachycardia

S S Prabhu, Sumitra Venkatesh.

Division of Pediatric Cardiology, B J Wadia Hospital for Children, Mumbai.

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Abstract
Supraventricular tachycardias (SVTs) are not rare in the paediatric age group, clinical presentations may vary and recognizing the diagnosis can be challenging. Nowadays most of the patients with SVTs can be cured by radiofrequency catheter ablation (RFA) of the accessory pathway or the focus of the tachycardia. In this report we describe a patient, who has been suffering from neuro-psychiatric symptoms for years until the cause, recurrent episodes of supraventricular tachycardia, was revealed. At the age of four years, the boy started to be hyperactive and showed poor concentration. Symptoms persisted despite various therapies. At the age of ten years, exercise tolerance decreased and a fast heart rate was noticed during "pulse diagnostic" in view of hyperactivity therapy. A 12 lead ECG showed a supraventricular tachycardia with 160 bpm. Echocardiography revealed a left ventricular dimension at the upper normal limit and a moderately impaired contractility. A treatment with Amiodarone was initiated and the mean heart rate was reduced although no definitive termination of the tachycardia was achieved. Cardiac function normalised within five days. The intracardiac electrophysiologic study confirmed an atrioventricular reentrant mechanism on the basis of a left-sided accessory pathway, which was successfully ablated.

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