Treating Supraventricular Tachycardia in Newborns
Supraventricular tachycardia (SVT) occurs when conduction of electrical impulses travels along an accessory connection from the atrium to the ventricle (atrioventricular reentry tachycardias) or when conduction takes place within the atrioventricular node (atrioventricular node reentry tachycardia). SVT is technically defined as pulse rates that exceed 180 bpm in children and adolescents and 220 bpm in infants.Infantile-onset SVT classically presenting in the first month or two of life is the most common sustained arrhythmia with an incidence of one in 250 infants. SVT is not uncommon with congenital heart disease, but it most commonly occurs in infants with structurally normal hearts.A 4-week-old recently presented to the pediatric emergency department with a heart rate in the 290s. The mother, a nurse practitioner, had first noted the fast heart rate the prior evening. The infant had continued eating and drinking normally, and showed no signs of heart failure, fatigue, or distress. Brief applications of ice to the infant's face failed to stimulate a vagal effect sufficient enough to break the SVT. A second dose of adenosine broke the abnormal rhythm, and the infant was admitted to the PICU for observation.Watch a video of this patient's management.SVT Treatment SpecificsThe basic steps of treating neonatal SVT are:Assess the patient and categorize him as stable (normal capillary refill time, mental status, and blood pressure) or unstable.Stable patients are managed w...
Source: M2E Too! Mellick's Multimedia EduBlog - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
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