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Recognising supraventricular tachycardia in children: An arrhythmia not to miss

07 December 2012
Features
02 December 2012
Volume 4 · Issue 12

Supraventricular tachycardia (SVT) is the most common symptomatic arrhythmia in children that demands urgent medical attention. This article describes the caveats in diagnosing and managing children with SVT in the pre-hospital setting. It is important that the paramedic team arranges urgent transfer of a child with SVT to the emergency department. The pre-hospital management should include obtaining an electrocardiogram (ECG), administering oxygen and attempting vagal manoeuvres such as carotid sinus massage while en route to hospital. It is also important that the paramedic team should actively look for clues for the sudden onset of SVT in a child such as the presence of illegal drugs at home, a history of accidental ingestion of parents’ medicines, and a family history of arrhythmias. The clinical presentation of SVT varies with the child's age, and can be difficult to diagnose in infants and young children. It is important that paramedic teams consider a diagnosis of SVT in young children with histories of poor feeding, lethargy, irritability, excessive sweating or pallor and in older children with a history of palpitations, dizziness, chest pain, syncope or shortness of breath.

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