Cardiovascular system
Jagdish M. Gupta, John Beveridge in MCQs in Paediatrics, 2020
8.3. A previously well 3-month-old infant presents with reluctance to feed and breathlessness. The pulse rate is 280/min. Which of the following is/are correct?The most likely diagnosis is supraventricular tachycardia (SVT).Diagnosis of Wolff-Parkinson-White (WPW) syndrome can be confirmed during remission by ECG.Facial immersion in ice water is effective treatment.Verapamil is the recommended treatment in this patient.The infant is unlikely to have relapses.
Investigations for abnormal cardiac electrophysiology
Ever D. Grech in Practical Interventional Cardiology, 2017
The patient history should be the starting point. Sustained episodes of palpitation should be differentiated from brief intermittent symptoms due to ectopic beats. Sudden onset and offset of episodes are typical for supraventricular tachycardia (SVT). Previous attendances to the emergency room for adenosine treatment, or the ability to terminate episodes with vagal manoeuvres is helpful information. Age of symptom onset in childhood would be more consistent with the presence of an accessory pathway. A ‘red flag’ symptom is syncope or pre-syncope, which may indicate significant haemodynamic compromise from arrhythmia. If one suspects ventricular arrhythmia, awareness of the presence of structural heart disease, or cardiomyopathy is important.
Cardiology
Timothy G Barrett, Anthony D Lander, Vin Diwakar in A Paediatric Vade-Mecum, 2002
Supraventricular tachycardia (SVT) is the commonest form of dysrhythmia in infants. An ECG can be faxed to a paediatric cardiology centre for confirmation. Initial treatment includes application of an icebag to the face. Digoxin, 5 µg/kg IV is sometimes effective. Adenosine, administered using the correct dosage schedule, usually converts SVT into sinus rhythm, and must be given by rapid bolus (see Chapter 34 for dosage schedule), but reversion to SVT is common and can usually be prevented by pretreatment with another anti-arrhythmic drug. Unresponsive cases should be transferred rapidly to the referral centre.
Etripamil nasal spray: an investigational agent for the rapid termination of paroxysmal supraventricular tachycardia (SVT)
Published in Expert Opinion on Investigational Drugs, 2020
Anthony H. Kashou, Peter A. Noseworthy
Paroxysmal supraventricular tachycardia (SVT) represents an array of regular, often narrow complex, rapid rhythms with sudden onset and termination. The most common forms of SVT are atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentry tachycardia (AVRT) which both include the AV node as an essential limb of the reentrant circuit. Less commonly, atrial tachycardia (AT) can arise for a focal atrial site, but this arrhythmia is not an AV nodal-dependant reentrant rhythm. The prevalence of SVT in the general population is 2–3 per 1,000 people, with an estimated age- and sex-adjusted incidence of 35 per 100,000 people per year in the United States [1]. There are approximately 570,000 people with SVT and about 89,000 new cases each year [1].
An interesting case of wide QRS tachycardia with left bundle branch block morphology
Published in Acta Cardiologica, 2019
Krishna Kumar Mohanan Nair, Narayanan Namboodiri, Hiren Kevadiya, Ajitkumar Valaparambil
A 30 year old gentleman is evaluated for recurrent palpitations. He has no underlying structural heart disease. During one of the episodes a regular wide complex tachycardia with left bundle branch block (LBBB) morphology, left inferior axis and late precordial transition is recorded (Figure 1, Panel A). No preexcitation is documented on basal surface electrocardiogram. The differential diagnosis entertained at this point are supraventricular tachycardia (SVT) with LBBB aberrancy, ventricular tachycardia and preexcited tachycardia – antidromic AV re-entrant tachycardia. He has undergone an electrophysiological study which showed progressive preexcitation on incremental pacing from right atrial free wall making ventricular tachycardia less likely. Atrial pacing induced clinical tachycardia which has identical QRS pattern as that during maximal preexcitation. During the LBBB tachycardia there is 1:1 AV relation, negative HV interval and right bundle (RB) electrogram (EGM) preceded the His bundle (HB) EGM (Figure 1, Panel B). Negative HV interval during tachycardia excludes SVT with LBBB aberrancy as the mechanism. Mapping catheter positioned at 8’O clock of the lateral tricuspid annulus showed a sharp high frequency signal, accessory pathway potential (AP), between the atrial and the ventricular electrograms. In view of the progressive preexcitation on incremental atrial pacing, negative HV interval during the LBBB tachycardia, preceding RB EGM to HB EGM during the tachycardia and demonstration of accessory pathway potential at 8’O clock of the lateral tricuspid annulus diagnosis of antidromic AV re-entrant tachycardia involving atriofascicular bypass tract is made and successfully ablated.
Pregnancy in women with congenital heart disease: a focus on management and preventing the risk of complications
Published in Expert Review of Cardiovascular Therapy, 2023
Gurleen Wander, Johanna A. van der Zande, Roshni R Patel, Mark R Johnson, Jolien Roos-Hesselink
Management. Patients who are at low risk (mWHO class II) can be seen by a cardiologist in each trimester. Those in mWHO class III need monthly/bimonthly MDT follow up. Supraventricular tachycardia (SVT) can complicate pregnancy and may need vagal maneuvers or, if resistant, chemical or electrical cardioversion. Severe tricuspid regurgitation (TR) with HF can mostly be managed medically during pregnancy. However, women with interatrial shunts are at an increased risk of paradoxical emboli and if cyanosed, this may increase worsening maternal and fetal outcomes.
Related Knowledge Centers
- Atrial Fibrillation
- Atrial Flutter
- Palpitations
- Shortness of Breath
- Tachycardia
- Atrium
- Ventricle
- Ventricular Tachycardia
- Paroxysmal Supraventricular Tachycardia
- Wolff–Parkinson–White Syndrome
- Shortness of Breath