Presentation
Most, 36 (72%), presented within the first 48 h of life. Congestive heart failure was evident in 10 infants, with 6 presenting at 1 day of age, and 4 presenting beyond 1 month of age. The remainder were asymptomatic. [onlinejacc.org]
Presently baby is 6 months old and there is no recurrence. [pediatriconcall.com]
Patients that present with a new finding of WPW can often present with atrial fibrillation, along with symptoms such as those described above. [quizlet.com]
Peak age of presentation is late teenage years to the 20s, and a common presenting symptom is syncope with exercise. [onlinejets.org]
In the present series, adenosine and/or diltiazem were helpful both to establish the diagnosis and for initial management of the patient who presented with fast tachycardia and narrow QRS complex (eight of the 19 patients). [onlinelibrary.wiley.com]
Entire Body System
- Asymptomatic
[…] arrhythmias and thromboembolism, we recommend surgery even if the patients are asymptomatic. 1. [annalspc.com]
To date, the patient has remained asymptomatic. [revespcardiol.org]
Our extensive experience among children with tachyarrhythmias has substantially contributed to the scientific literature progress in order to revisit current guidelines particulary in asymptomatic children with ventricular preexcitation. [af-ablation.org]
Most patients (33 of 50, 66%) had a single episode of AFL, were asymptomatic, and easily converted to sinus rhythm. [onlinejacc.org]
One asymptomatic infant converted to normal sinus rhythm 24 hours following digoxin administration. One infant had multiple atrial flutter recurrences and required chronic procainamide therapy. [pediatrics.aappublications.org]
- Fatigue
It is important to visit your child’s healthcare provider if your child displays any of these symptoms: Weakness or fatigue; tiring easily with exercise Pounding, pain or pressure in the chest Shortness of breath Fainting or lightheadedness Your doctor [heart.org]
Presentation Bradycardia may be asymptomatic but can present with syncope, fatigue or dizziness. [patient.info]
But you may feel Palpitations -- an abnormal rapid heartbeat Shortness of breath Weakness or difficulty exercising Chest pain Dizziness or fainting Fatigue Confusion AF can lead to an increased risk of stroke. [fpnotebook.com]
That can cause: Chest pain Dizziness Fatigue Shortness of breath Continued Treatments One treatment for SVT uses medicine to slow the heartbeat. If that doesn't fix the problem for you, another option is called ablation. [webmd.com]
The patient's symptoms are usually decreased ability to walk, muscle pain, and fatigue. [quizlet.com]
- Collapse
[…] of chest pain or collapse. [patient.info]
Most atrial flutter cases in neonates have a benign course, but some cases that occur along with congenital heart disease can result in a high risk of an intractable tachycardia attack with hemodynamically cardiac collapse. [omicsonline.org]
Metabolic acidosis results from decreased cardiac output (as in cardiovascular collapse and shock), leading to poor perfusion of peripheral tissues and lactic acidosis. [usmleforum.com]
Cardiovascular collapse after verapamil in supraventricular tachycardia. Arch Dis Child 1987 ; 62: 1265 – 82. Google Scholar | Crossref | Medline 104. Gulamhusein, S, Ko, P, Carrutners, SG, Klein, GJ. [journals.sagepub.com]
George X collapsed in town. David X had an ‘out of body’ experience and ‘strange floating sensations’ while driving. [healthtalk.org]
- Fever
[…] hypertrophic cardiomyopathy, ischemic heart disease, Lown-Ganong-Levine syndrome, mitral regurgitation, mitral valve prolapse, mitral valve stenosis, myocardial infarction, myocardial ischemia, neonatal coxsackie myocarditis, pericarditis, rheumatic fever [wikidoc.org]
Common general physical exam findings include anxiousness, diaphoresis, and a low-grade fever. [quizlet.com]
[…] accident. 8 Peripheral thromboembolism and stroke, which can occur in the presence of bradycardia-tachycardia syndrome (alternating bradyarrhythmias and tachyarrhythmias), may be related to dysrhythmia-induced emboli. 3 A slow heart rate in the presence of fever [aafp.org]
[…] coccidioidomycoses, Actinomyces Neuromuscular disorders Duchenne muscular dystropy, Friedreich ataxia, other muscular dystrophies Nutritional factors Kwashiorkor, pellagra, thiamine deficiency, selenium deficiency Collagen vascular diseases Rheumatic fever [transplantbuddies.org]
- Hypothermia
Hypothermia. Cushing's reflex (systemic response to raised intracranial pressure, leading to widening pulse pressure, irregular breathing and bradycardia). Acute myocardial infarction. Sick sinus syndrome. Pericardial tamponade. [patient.info]
Moderate hypothermia in the management of resistant automatic tachycardias in children. Br Heart J 1991 ; 66: 221 – 4. Google Scholar | Crossref | Medline 42. Till, JA, Rowland, E. [journals.sagepub.com]
Crossref Cardosi RJ, Chez RA, Magnesium sulfate, maternal hypothermia, and fetal bradycardia with loss of heart rate variability, Obstet Gynecol, 1998;92:691–3. [ecrjournal.com]
Although this drug is associated with few side effects, maternal hypothermia and fetal bradyarrhythmias have been observed. [escardio.org]
[…] depends on gestational age, postnatal age, and birthweight >7 days, >2000 g: 60 mg/kg/d IV divided q6-8h Contraindications Documented hypersensitivity Interactions Concurrent administration with anesthetic agents can cause erythema, hypotension, and hypothermia [usmleforum.com]
Cardiovascular
- Heart Disease
The most common causes of atrial flutter are coronary artery disease, hypertensive heart disease and valve abnormalities of the heart. [wikidoc.org]
chronic pulmonary disease, stroke, heart failure, congenital heart disease, Wolff-Parkinson-White syndrome). [thecardiologyadvisor.com]
An understanding of the variety of diseases that can predispose children with normal hearts or with structural heart disease to arrhythmias is essential for appropriate treatment. 1. Doniger SJ, Sharieff GQ. Pediatric dysarrhythmias. [onlinejets.org]
It is caused by accessory pathways sometimes associated with certain forms of congenital heart disease. [escardio.org]
Ischemic Heart Disease Coronary angiography is necessary for establishing the presence or absence of coronary heart disease and to detect congenital coronary anomalies. [circ.ahajournals.org]
- Left Ventricular Dysfunction
Improvement in left ventricular dysfunction after control of persistent tachycardia. J Pediatr 1984 ; 105: 543 – 8. Google Scholar | Crossref | Medline 67. Olsson, SB, Blomstrom, P, Sabel, K, William-Olsson, G. [journals.sagepub.com]
This type of manifestation is presumably due to diminished left ventricular contractility and an inappropriately thin left ventricular wall, resulting in elevated wall stress and progressive LV dysfunction. [transplantbuddies.org]
The patient with hemodynamically stable VT in the setting of significant left ventricular dysfunction should be treated with intravenous amiodarone. [quizlet.com]
- Continuous Murmur
This murmur is described as a hollow, machinery-like murmur that is continuous throughout the cardiac cycle. [quizlet.com]
Musculoskeletal
- Osteoporosis
Early / 0-13.6 thrombocytopenia / Delayed / 0-13.6 elevated hepatic enzymes / Delayed / 4.2-9.5 hematoma / Early / 0-7.1 subdural hematoma / Early / Incidence not known hematuria / Delayed / Incidence not known bullous rash / Early / Incidence not known osteoporosis [pdr.net]
Neurologic
- Stroke
Atrial flutter (AFL) is less common than AF but more difficult to control with drugs and is also associated with an increased risk of stroke. In some patients these arrhythmias may be asymptomatic but still result in heart failure or stroke. [thecardiologyadvisor.com]
Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation: analysis of pooled data from five randomized controlled trials. Seite 140 - Wang Q, Shen J, Splawski I et al. [books.google.de]
This arrhythmia accounts for about one-third of all strokes, and 30% of all patients with atrial fibrillation have a family history of the disease. [nature.com]
There it might block blood flow, causing a stroke. Certain medications, such as blood thinners, can greatly lower your risk of stroke or damage to other organs caused by blood clots. [mayoclinic.org]
Take advantage of a wealth of images that capture the clinical manifestations and findings associated with Kawasaki disease, lupus, lymphoma, stroke, and many other disorders seen in children. [books.google.ro]
Workup
WORKUP Section 5 of 11 Author Information Introduction Clinical Differentials Workup Treatment Medication Follow-up Miscellaneous Pictures Bibliography Lab Studies: Initial presentation usually includes subtle signs of feeding intolerance, such as gastric [usmleforum.com]
Continuing the esmolol infusion and monitoring is also important but this patient also needs further workup, i.e. cardiac catheterization, prior to going to the operating room. [quizlet.com]
Rhythm
- Sinus Arrhythmia
An athlete may show sinus arrhythmia but this is rare beyond 30. Note any shift in the cardiac apex. Aetiology Sinus bradycardia may be physiological with a high resting vagal tone - eg, in athletes or the diving reflex. [patient.info]
The selected tracings illustrate: (A) Recording at rest, showing sinus arrhythmia with rates varying from 50 to 78 beats/min and occasional atrial and ventricular premature beats; (B) recording obtained during the early part of exercise, showing sinus [onlinelibrary.wiley.com]
Sinus bradycardia (heart rate 100bpm: 9% in G I, 10% in G II; p=NS) were relatively rare, whereas there was a high frequency of sinus arrhythmias in both groups (61% in G I, 69% in G II; p=NS). [ecrjournal.com]
Medical therapy alone does not protect the patient from arrhythmias, and ablation therapy is not indicated for this type of arrhythmia. [quizlet.com]
- Premature Atrial Contractions
[…] supraventricular tachyarrhythmias can occur in the fetus and neonate, including premature atrial contractions, ectopic atrial tachycardia, atrial flutter, and supraventricular tachycardia. [hw-f5-neoreviews.highwire.org]
The most commonly diagnosed fetal arrhythmias are premature atrial contractions (PACs), which often resolve soon after birth. [accesspediatrics.mhmedical.com]
Treatment
It concluded that catheter ablation had a lower cost, mortality and morbidity than drug treatment or surgery and should be the treatment of choice in that situation. [indianpediatrics.net]
If the arrhythmia persists after correction of all factors, treatment should be provided. [escardio.org]
Management and treatment The first aim of treatment is the restoration of sinus rhythm. This is most easily achieved by transoesophageal overdrive pacing or synchronised low energy DC cardioversion using around 0.5-1 J/kg. [orpha.net]
The preferred drug for treatment of APBs is a β1-selective agent (metoprolol). [ecrjournal.com]
Prognosis
CONCLUSIONS: Neonatal atrial flutter is an arrhythmia with significant acute morbidity but an excellent long-term prognosis. [ncbi.nlm.nih.gov]
Prognosis In the absence of additional arrhythmias, infants with AFL have an excellent prognosis once in sinus rhythm, with a low risk of recurrence, and chronic anti arrhythmic therapy is unlikely to be necessary. [orpha.net]
Isolated neonatal atrial flutter: clinical features, prognosis and therapy. G Ital Cardiol 1998 ; 28 : 365 – 368. [cambridge.org]
Once in sinus rhythm, infants with AF have an excellent prognosis and may not require chronic antiarrhythmic therapy. (5) This baby did not have underlying congenital heart disease, electrolyte imbalance or any other associated arrhythmia hence was not [pediatriconcall.com]
Pathophysiology is emphasized throughout, providing a sound basis for discussions of the diagnosis, treatment, and prognosis that follow. [books.google.de]
Etiology
AFL is sustained although conversion from atrial flutter to sinus rhythm may occur spontaneously ( Etiology The etiology of AFL is unknown but immaturity of the myocardium and the high pressure in the right atrium during the perinatal period may be factors [orpha.net]
Etiology – Atrial Flutter The etiology of atrial flutter is similar to that of atrial fibrillation. Identifying the etiology of cannot be under-emphasized, as treating the cause is frequently necessary to eliminate recurrences of atrial flutter. [healio.com]
Tiwari S, Sahu M View full Text pdf Etiological spectrum and complications of acute diarrhoeal diseases in adults. [ijrrms.com]
[from ORDO ] Etiology Pacing Clin Electrophysiol 2016 Aug;39(8):792-6. Epub 2016 Jun 7 doi: 10.1111/pace.12888. PMID: 27196949 Till J, Wren C Br Heart J 1992 Jan;67(1):80-3. doi: 10.1136/hrt.67.1.80. [ncbi.nlm.nih.gov]
Epidemiology
Aliases & Classifications for Idiopathic Neonatal Atrial Flutter MalaCards integrated aliases for Idiopathic Neonatal Atrial Flutter: Name: Idiopathic Neonatal Atrial Flutter 60 Characteristics: Orphanet epidemiological data: 60 idiopathic neonatal atrial [malacards.org]
Anatomy, Physiology, and Epidemiology of Arrhythmias. ECGs and Other Recording Devices. Other Diagnostic Techniques. The Normal ECG and Variants. Interpretation of the ECG in Tachycardia. Adenosine in the Diagnosis of Tachycardias. [terkko.helsinki.fi]
Summary Epidemiology AFL is rare with an approximate incidence of around 1/50,000 live births in Europe. Clinical description AFL has a neonatal onset and the majority (72%) of patients present with symptoms within the first 48 h of life. [orpha.net]
We aim to provide a comprehensive review of the epidemiology and pathophysiology by which alcohol may be responsible for AF and determine whether alcohol abstinence is required for patients with AF. [onlinejacc.org]
Pathophysiology
Pathophysiology is emphasized throughout, providing a sound basis for discussions of the diagnosis, treatment, and prognosis that follow. [books.google.de]
This review describes the pathophysiology and corresponding electrocardiographic findings of each arrhythmia. In addition, this summary compares the clinical findings, management, and outcomes of these arrhythmias during fetal and postnatal life. [hw-f5-neoreviews.highwire.org]
To date, the pathophysiological mechanisms responsible for AF are not fully understood, and it is likely that this arrhythmia represents a final common phenotype of multiple. [ingentaconnect.com]
Prevention
It aims to reduce delays in recognising and treating sick babies and prevent unnecessary use of antibiotics. [nice.org.uk]
Succinct, targeted coverage of normal childhood growth and development, as well as the diagnosis, management, and prevention of common pediatric diseases and disorders, make this an ideal medical reference book for students, pediatric residents, nurse [books.google.ro]
To prevent recurrences, we treated four patients with amiodarone, one with amiodarone combined with propranolol and one with digoxin. During the follow-up (22 +/- 11 months), neither arrhythmia recurrences nor side-effects of the therapy occurred. [ncbi.nlm.nih.gov]