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Gepubliceerd in: Netherlands Heart Journal 10/2021

Open Access 03-08-2021 | Rhythm Puzzle – Question

Tachycardia in a teenager

Auteurs: Y. R. Persia-Paulino, J. Rozado, D. Perez

Gepubliceerd in: Netherlands Heart Journal | Uitgave 10/2021

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A 14-year-old patient was brought to the emergency room (ER) due to palpitations. Her father had suffered sudden death aged 30 years. She had no toxic habits. When examined 4 months previously due to palpitations, her electrocardiogram (ECG) and echocardiogram were normal. On arrival at the ER she was conscious, with a blood pressure of 96/64 mm Hg, heart rate of 160 beats/min and a ventilation frequency of 14 breaths/min. Physical examination findings were severe tachycardia and normal heart sounds with no murmurs, as well as well-ventilated lung zones with no additional sounds. Fig. 1 shows the ECG at ER admission.
Vagal and modified vagal manoeuvres were performed but had no effect on the tachycardia. Three doses of intravenous adenosine (6 mg, 12 mg and 12 mg) were administered but neither stopped the tachycardia nor lowered the heart rate. During continuous ECG monitoring at the ER, her heart rate increased to 210 beats/min when standing up, returning to 166 beats/min at rest. Electrical cardioversion was performed due to hypotension (80/60 mm Hg) after adenosine administration; the ECG is shown in Fig. 2.
What do you think was the cause of this tachycardia?

Answer

You will find the answer elsewhere in this issue.
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Metagegevens
Titel
Tachycardia in a teenager
Auteurs
Y. R. Persia-Paulino
J. Rozado
D. Perez
Publicatiedatum
03-08-2021
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 10/2021
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-021-01610-6

Andere artikelen Uitgave 10/2021

Netherlands Heart Journal 10/2021 Naar de uitgave

Rhythm Puzzle – Answer

Tachycardia in a teenager