Discussion :
1} HR-250, min {2} ‘P’ is not seen easily occasionally seen merged with with T wave. Rhythm regular. Absence of ‘p” differentiates it from sinus tachycardia. QRS is not widened i.e. narrow QRS tachycardia suggestive of supraventricular tachycardia probably proximal to bifurcation of bundle of axis.
Diagnosis – Supraventricular tachycardia {SVT}
SVT -Abnormal rhythm resulting from ectopic focus in atria or AV node, or from accessory conduction pathways. Characterized by varying P-wave shape and abnormal P-wave axis. QRS morphology is usually normal
Cause -Most commonly idiopathic but may be seen in congenial heart disease {e.g., Ebstein’s anomaly, transposition}
Treatment –
If child stable - Vagal maneuvers and, or IV Adenosine {0.1- 0.2 mg, kg} as bolus `
If child unstable, needs immediate synchronized cardioversion {0.5 j, kg up to 1 j, kg}.
E-published: September 2007 Vol 4 Issue 9, Art # 39 |
| Correct Answers : |  61% |
Last Shown : Aug 2007
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