Pediatric paroxysmal tachycardia
Introduction
Introduction to children with paroxysmal tachycardia Pediatric paroxysmal tachycardia is a type of ectopic tachycardia. According to its origin, both subventricular and ventricular, the vast majority of cases belong to supraventricular tachycardia. Paroxysmal ventricular tachycardia should be distinguished from non-paroxysmal ventricular tachycardia, which is an accelerated ventricular autonomic rhythm whose ventricular rate is close to or slightly faster than sinus rhythm, and more Caused by hemodynamic changes, children often asymptomatic, PVT and PS-VT with wide QRS wave identification in the PSVT section already mentioned. Children often suddenly irritated, pale gray or gray, cold skin, increased breathing, weak pulse, often accompanied by dry cough, sometimes vomiting, older children can also complain of palpitations, precordial area, dizziness and so on. The heart rate suddenly increases at the time of onset, 160 to 300 beats / min, most > 200 beats / min, an episode lasts from a few seconds to a few days. The heart rate suddenly slows down when the attack stops. In addition, the intensity of the first heart sound is completely the same at the time of auscultation, and the heart rate is fixed and the rules are the characteristics of the disease. Heart failure occurs when the seizure lasts for more than 24. If there is an infection at the same time, there may be fever, peripheral white blood cells and other manifestations. basic knowledge The proportion of illness: 0.001% Susceptible people: good for children Mode of infection: non-infectious Complications: coronary heart disease myocardial infarction heart failure angina
Cause
Pediatric paroxysmal tachycardia
Direct cause (40%):
Can occur in congenital diseases, pre-excitation syndrome, myocarditis, endocardial fibroelastosis and other diseases, but most children have no organic disease.
Other incentives (30%):
Infection is a common cause, but it can be induced by cause, spirit, excessive ventilation, and later, cardiac catheterization.
Prevention
Pediatric paroxysmal tachycardia prevention
Actively prevent congenital heart disease; actively treat primary disease, prevent electrolyte imbalance and acid-base imbalance, such as various gastrointestinal diseases, uremia, rheumatic fever, viral myocarditis, cardiomyopathy, Kawasaki disease, nervous system factors, hypothermia, anesthesia and drug poisoning Arrhythmia caused by etc.
Complication
Pediatric paroxysmal tachycardia complications Complications, coronary heart disease, myocardial infarction, heart failure, angina
This disease often occurs in a variety of patients with structural heart disease. The most common is coronary heart disease, especially in patients with myocardial infarction. Followed by cardiomyopathy, heart failure, mitral valve prolapse, valvular heart disease, etc., in some cases, can also occur in patients with no structural heart disease, in these patients with significant structural heart disease, It can be complicated by angina pectoris, acute left heart failure, and complications such as Aspergic syndrome. Sudden death can occur in severe cases.
Symptom
Symptoms of paroxysmal tachycardia in children Common symptoms Breathing rush, complexion, gray, gray, irritability, discomfort, increased dizziness, heart palpitations
Children often suddenly irritated, pale gray or gray, cold skin, increased breathing, weak pulse, often accompanied by dry cough, sometimes vomiting, older children can also complain of palpitations, precordial area, dizziness and so on. The heart rate suddenly increases at the time of onset, 160 to 300 beats / min, most > 200 beats / min, an episode lasts from a few seconds to a few days. The heart rate suddenly slows down when the attack stops. In addition, the intensity of the first heart sound is completely the same at the time of auscultation, and the heart rate is fixed and the rules are the characteristics of the disease. Heart failure occurs when the seizure lasts for more than 24. If there is an infection at the same time, there may be fever, peripheral white blood cells and other manifestations.
Examine
Pediatric paroxysmal tachycardia examination
1. X-ray depends on the presence or absence of organic lesions and heart failure. See the pulsation weakened under fluoroscopy.
2. Electrocardiogram P wave morbidity abnormality, often small, often overlaps with the previous heartbeat T wave, so that it is indistinguishable. The QRS wave has the same shape as the sinus. The seizure lasts longer, and the ST segment and T wave can change. Some children may have pre-excitation syndrome during the onset of seizures. Sometimes it needs to be differentiated from sinus tachycardia and ventricular tachycardia.
Diagnosis
Diagnosis and diagnosis of paroxysmal tachycardia in children
diagnosis
According to the clinical manifestations of the medical history, it is ultimately dependent on ECG to confirm the diagnosis.
Differential diagnosis
Paroxysmal ventricular tachycardia should be distinguished from non-paroxysmal ventricular tachycardia, which is an accelerated ventricular autonomic rhythm whose ventricular rate is close to or slightly faster than sinus rhythm, and more Caused by hemodynamic changes, children often asymptomatic, PVT and PS-VT with wide QRS wave identification in the PSVT section already mentioned.
