Question
An 8-month-old female child presented to emergency with a heart rate of 220/minute and features of congestive heart failure. Her heart rate comes down to normal after intravenous administration of the drug shown in the picture below.What is the most likely diagnosis?
| A. |
Atrial fibrillation.
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| B. |
Atrial flutter.
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| C. |
Paroxysmal supraventricular tachycardia.
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| D. |
Ventricular tachycardia.
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Show Answer
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Correct Answer � C
Explanation
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Ans:.C) Paroxysmal supraventricular tachycardia.
Adenosine is the drug of choice for Paroxysmal supraventricular tachycardia.
* Paroxysmal supraventricular tachycardia (paroxysmal SVT)
* It is an episodic condition with an abrupt onset and termination.
* SVT in general is any tachyarrhythmia that requires atrial and/or atrioventricular (AV) nodal tissue for its initiation and maintenance.
* Palpitations and dizziness are the most common symptoms reported by patients with SVT. Chest discomfort may be secondary to a rapid heart rate, and it frequently subsides with the termination of the tachycardia. Persistent SVT may lead to tachycardia-induced cardiomyopathy.
* Acute management of paroxysmal supraventricular tachycardia(PSVT) includes controlling the rate and preventing hemodynamic collapse.
– If the patient is hypotensive or unstable, immediate cardioversion with sedation must be performed.
– If the patient is stable, vagal maneuvers can be used to slow the heart rate and to convert to sinus rhythm.
– If vagal maneuvers are not successful, adenosine can be used in increasing doses.
– If adenosine does not work, atrioventricular (AV) nodal blocking agents like calcium channel blockers or beta-blockers should be used, as most patients who present with PSVT have AV nodal reentrant tachycardia (AVNRT) or AV reentrant tachycardia (AVRT).
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