Pediatric emergency medicine trisk 1523 1523
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Tachyarrhythmias
SVT represents the most common tachyarrhythmia of childhood (see Chapter 86
Cardiac Emergencies ). The typical heart rate in infants with SVT exceeds 220
beats per minute, whereas older children usually have a heart rate in excess of
180 beats per minute. Infants and children with SVT demonstrate a range of
physical signs including no symptoms, palpitations, chest pain, tachypnea (often
with feeding in infants), diaphoresis, and severe cardiogenic shock.
TABLE 77.1
DIFFERENTIAL DIAGNOSIS OF TACHYCARDIA
Sinus tachycardia
Fever
Crying
Pain
Hypoglycemia
Hypoxemia
Hypercarbia
Shock
Anemia
Poisoning (see Table 63.4 )
Sepsis
Anaphylaxis
Hyperthyroidism
Pheochromocytoma
Drug induced (e.g., antihistamines, caffeine, dietary supplements)
Withdrawal (e.g., alcohol, benzodiazepines, opiates)
Anxiety
Myocarditis
Acute rheumatic fever
Kawasaki disease
Pericardial effusion with tamponade
Tachyarrhythmias
Supraventricular tachycardia
Atrial flutter
Ventricular tachycardia (monomorphic and polymorphic/torsades de pointes)
