Arrhythmia responding to Adenosine

Vivek Sharma

doi:https://10.7199/ped.oncall.2012.33

IMAGES IN CLINICAL PRACTICE

Arrhythmia responding to Adenosine

Vivek Sharma.

Department of Pediatrics, Tata Motors Hospital, Jamshedpur, India.

ADDRESS FOR CORRESPONDENCE
Dr Vivek Sharma, M-36, 4, Telco colony, Jamshedpur, Jharkhand - 831004.
Email: dr_viveksharma@yahoo.com

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A 17 day old baby presented with complaints of vomiting every feed and excessive crying. Child had BCG vaccination just 3 days ago and parents were attributing excessive cry due to pain following vaccination. But on examination there was a heart rate of 300, min, though no murmur could be heard with respiratory distress and hepatomegaly. Chest x-ray showed cardiomegaly. Electrocardiogram {ECG} showed narrow QRS complex with absent P wave. Child was given oxygen and IV adenosine at a dose of 0.1mg, kg was given by rapid flush technique. Cardiac rhythm reverted to normal sinus rhythm. Further ECG was done which showed presence of delta wave which is a slurred upstroke in the QRS complex with short PR interval. Echocardiography and Holter monitoring were normal. Child was put on propranolol and is doing fine since then.