Arrhythmias in Children

<ol> <li>Newborn/Infant</li> <ol> <p> <li>Newborn nursery infant that has bradycardia</li> <ol> <p> <li>What am I thinking about?</li> <p> <li>History and Physical</li> <p> <li>Differential Diagnosis</li> <ol> <p> <li>Fetus with premature beats</li> <p> <li>Newborn with complete heart block</li> <p> <li>Hypothyroidism</li> <p> <li>Medication-induced</li> <p> <li>Apnea</li> </ol> <p> <li>Tests to Order</li> <p> <li>Practical Plan of Action</li> </ol> <p> <li>NICU infant noted to have extrasystoles on cardiac monitor</li> <p> <li>Full-term infant noted to have persistent tachycardia</li> <p> <li>2-month-old presenting to the ER with tachycardia, fussy, unable to eat</li> <p> <li>4-month-old with extrasystoles on auscultation at pediatrician’s office</li> <p> <li>9-month-old with recurrent episodes of supraventricular tachycardia despite medical therapy </li> </ol> <p> <li>Child</li> <ol> <p> <li>2-year-old presents to ER with an episode of "passing out" and "turning blue"</li> <p> <li>3-year-old is noted by pediatrician to have a low resting heart rate</li> <p> <li>4-year-old presents to ER with supraventricular tachycardia</li> <p> <li>7-year-old presents to ER with recurrent SVT</li> <p> <li>8-year-old presents with ADHD presents to cardiology office with ECG in hand for "cardiac clearance" to start stimulants</li> <p> <li>10-year-old presents to ER with dizziness and bradycardia with a pacemaker that does not appear to be functioning</li> <p> <li>11-year-old whose father recently died at the age of 45</li> <p> <li>5-year-old, asymptomatic, with ECG obtained for physical demonstrating WPW</li> </ol> <p> <li>Pre-teen/Teenager</li> <ol> <p> <li>13-year-old with syncope while standing in line for lunch</li> <p> <li>15-year-old with intentional ingestion of grandparent’s calcium channel blockers</li> <p> <li>16-year-old with premature ventricular contractions noted during athletic participation physical.</li> <p> <li>14-year-old cross country runner presents with syncope during a race</li> <p> <li>15-year-old with syncope while playing soccer</li> <p> <li>17-year-old with palpitations and dizziness while playing football</li> <p> <li>14-year-old who had to be pulled from the pool during a swim meet</li> </ol> <p> <li>Special Circumstances</li> <ol> <p> <li>Maternal fetal evaluation reveals fetus with tachycardia</li> <p> <li>Maternal fetal evaluation reveals fetus with premature beats</li> <p> <li>A newborn infant with complete heart block noted immediately after birth</li> <p> <li>A 3-month old child with complete heart block after surgery for AV canal defect</li> <p> <li>A 4-month old post-operative ventricular septal defect with junctional ectopic tachycardia</li> <p> <li>A 2-year old child who took an overdose of grandmother’s digoxin pills</li> <p> <li>A 10-year old child with a "pacemaker" who is dizzy and had a syncope episode</li> <p> <li>An 11-year old child resuscitated from sudden collapse, found to have a long QT on ECG</li> <p> <li>A 12-year old with hypertrophic cardiomyopathy presents to the emergency room with syncope</li> <p> <li>A 13-year old with repaired tetralogy of Fallot with frequent PVCs</li> <p> <li>A 15-year old presents to ER after successful resuscitation with an AED for documented ventricular fibrillation</li> <p> <li>A 16-year old teen with a defibrillator who received a shock</li> </ol></ol>