ISSN - 0973-0958
Menu
Disease
A-Z
Health Topics
Alternative Medicine
Developmental Pediatrics
General Pediatrics
Genetics
Immunodeficiencies
Infectious Diseases
Laboratory Medicine
Neonatology
Nutrition
Pediatric Cardiology
View all Topics
Featured Articles
Circumcision
Urticaria (hives) and angioedema
Anaphylaxis
Diabetic ketoacidosis
Hypospadias
Anal fissure
Kids Corner
Health and Knowledge with fun.
Drugs &
Calculators
Medical Calculators
Drug Calculators
Growth Calculators
Renal Calculators
View all Calcualtors
Drug Index
ACE inhibitor
Alkylating agents
Allergies
View all Drugs
Poisoning Center
Aluminum phosphide
Anti-histaminics
Antidepressants
View all Drugs
Medical Eqipments
Monitors
Pumps
Incubators
View all Equipments
Diagnostic Aid
Get your diffrential
diagnosis.
Consult
& Posts
Ask a Doctor
Diagnostic Dilemma
Question of the Week
Pediatric Blogs
Spot Diagnosis
Grand Rounds
Pedi Poll
Pediatric
Journal
Current Issue
All Issues
Advance Access
About the Journal
Submit Article
Books
& Apps
Book Store
Pediatric Oncall
Medical Calculators
Vaccine Reminder
Pediatric Oncall Journal
Drug Center
Parenting
CME &
Videos
Upcoming Conferences
Conference Abstracts
MCQs
Videos
Vaccine
Reminder
Sign In
Home
Articles & Issues
Current Issue
All Issues
Advance Access
About
Pediatric Oncall Journal
Editorial Board
Peer Review Policy
Other Policies
Copyrights
Privacy Statement
Contribute
Open Access Statement
Authorship & Acknowledgment
Author Guidelines
Forms
Submit Manuscript
Dr Ira Shah
https://www.pediatriconcall.com/Journal/images/journal_cover.jpg
TEACHING FILES (GRAND ROUNDS)
Year :
January-March 2011
| Volume :
8
|
Issue :
1
Vomiting with Ventricular Septal Defect
Vomiting with Ventricular Septal Defect
16/11/2010
16/11/2010
Ira Shah
https://www.pediatriconcall.com/Journal/images/journal_cover.jpg
Dr Ira Shah.
Medical Sciences Department, Pediatric Oncall, Mumbai, India.
Cite this article
Shah I. Vomiting with Ventricular Septal Defect. Pediatr Oncall J. 2011;8: 29.
Address for Correspondence
Dr Ira Shah, 1, B Saguna, 271, B St Francis Road, Vile Parle {W}, Mumbai 400056. India
Clinical Problem :
A 6 month old boy with congenital moderate ventricular septal defect {VSD} on decongestive measures consisting of frusemide and digoxin presented with irritability, vomiting and oliguria since 2 days. There is no fever, refusal of feeds or lethargy. On examination, he is malnourished {weight = 4kg}, with some dehydration, has heart rate of 100 , min and a pansystolic murmur at the apex. Other systems are normal
Question :
What is the diagnosis_? How to treat_?
Expert Opinion :
This child has presented with vomiting and oliguria. Oliguria may be due dehydration and decreased intravascular volume. The dehydration is because of persistent vomiting. Vomiting could be because of several reasons such as infection, gastritis or drug induced. This child has no fever or refusal of feeds. Thus infection seems an unlikely cause. Gastritis in a normally feeding infant is unlikely {There being no infection or nil by mouth}. Thus vomiting seems to be drug induced. Digoxin in toxic levels can lead to vomiting. Digoxin toxicity can also lead to bradyarrhythmia. In this child even though the child is dehydrated, there is no tachycardia. {Though bradycardia is not present, the heart rate seems to have remained normal due to simultaneous dehydration}. Thus, in this child the diagnosis is Digoxin toxicity. Serum digoxin levels in the child were elevated {2.7 {Normal being Less than 2.2}} Digoxin toxicity when diagnosed, one should stop Digoxin till Digoxin levels return to normal. FAB antibodies can be used to prevent digoxin effect.
Funding:
None
Conflict of Interest:
None
DOI No. :
Cite this article as :
Shah I. Vomiting with Ventricular Septal Defect. Pediatr Oncall J. 2011;8: 29.
Journal Subscription
Pediatric Oncall Journal
Subscribe Now
This Article
Full Text
View Full Article (PDF)
Authors
Dr Ira Shah
[Google Scholar]
[Pubmed]
Other
Find Articles in same issue
Find Articles under same category
Cite this article as
Shah I. Vomiting with Ventricular Septal Defect. Pediatr Oncall J. 2011;8: 29.
Ask a Doctor
Recommended for you
Learning Disabilities (LD)
Giardiasis
Mumps
Calculators
Serum Osmolality
Emergency Drug Formula
Blood Indices
Apnea–Hypopnea Index
Therapeutic Drug Levels
Videos
Dr. Ira Shah | Pediatric Liver Diseases - Clinical Perspective
Diagnostic Dilemmas in TB #3 - BCG Adenitis: Do I treat with ATT or not?
Malaria: Types, Clinical Features, Diagnosis, Treatment & Drugs | Dr Ira Shah
View All
Pediatric Oncall Journal
Review Article
Metabolic Syndrome in Children: Definition, Risk Factors, Prevention and Management-A Brief Overview
Letter To Editor(Viewers Choice)
Multiple Bee Stings induced Multiorgan Dysfunction in a 4 Year Old Female
Images In Clinical Practice
Nail Changes in a Child with Acute Lymphoblastic Leukemia
This work is licensed under a
Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
Disclaimer: The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.
X
Sign In
Disease A-Z
Health Topics
Alternative Medicine
Developmental Pediatrics
General Pediatrics
Genetics
Immunodeficiencies
Infectious Diseases
Laboratory Medicine
Neonatology
Nutrition
Pediatric Cardiology
View all topics
Featured Articles
Circumcision
Urticaria (hives) and angioedema
Anaphylaxis
Diabetic ketoacidosis
Hypospadias
Anal fissure
Kids Corner
Drugs & Calculators
Medical Calculators
Drug Calculators
Growth Calculators
Renal Calculators
View all Calculators
Drug Index
ACE inhibitor
Alkylating agents
Allergies
View all Drugs
Poisoning Center
Aluminum phosphide
Anti-histaminics
Antidepressants
View all Drugs
Medical Eqipments
Monitors
Pumps
Incubators
View all Eqipments
Diagnostic Aid
Consult & Posts
Ask a Doctor
Diagnostic Dilemma
Question of the Week
Pediatric Blogs
Spot Diagnosis
Grand Rounds
Pedi Poll
Pediatric Oncall Journal
Current Issue
All Issues
Advance Access
About the Journal
Submit Article
Books & Apps
Book Store
Pediatric Oncall
Medical Calculators
Vaccine Reminder
Pediatric Oncall Journal
Drug Center
Parenting
CME & Videos
Upcoming Conferences
Conference Abstracts
MCQs
Videos
Vaccine Reminder
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0