Supraventricular tachycardia in infants: response to initial treatment
Article Abstract:
Supraventricular tachycardia is a heart rate in excess of 100 beats per minute, which originates in areas above the heart ventricles. This abnormal heart rhythm is dangerous and potentially fatal in young infants. Early diagnosis and treatment of supraventricular tachycardia results in an excellent outcome. In the past, either the drug digoxin or cardioversion, the application of electric shock to restore a normal heart rhythm, was used to initially treat this heart disorder. However, digoxin is not always effective, and cardioversion requires anesthesia and sedation, which may be difficult to repeat for recurrent tachycardia. Other drugs, such as verapamil, disopyramide, and propranolol, given directly into the circulation have been used but may cause adverse effects. The effectiveness and safety of various types of treatment of supraventricular tachycardia in infants were assessed. This study involved 29 infants who developed supraventricular tachycardia in the first 12 months of life, and included 22 cases of heart failure and seven cases of cardiogenic shock, or inadequate blood flow due to inability of the heart to pump blood. Symptoms of supraventricular tachycardia were absent in seven infants. All babies had a heart rate of 215 to 315 beats per minute. Digoxin was effective in seven of 14 digoxin-treated patients, but caused an overdose in three patients. Verapamil was effective in all three patients treated with it, but caused a death in one patient. Cardioversion was effective in all 10 patients who received this form of treatment. The application of iced water to the face was effective in all 16 patients treated by this approach in 53 of 59 attacks. Treatment at regional referral centers was more effective and associated with fewer complications than treatment at local hospitals. These results show that digoxin is often not effective, may delay recovery of normal heart rhythm, and is commonly associated with overdosing. Although effective, cardioversion does not prevent recurrent tachycardia. The application of iced water to the face is both a safe and effective method of managing supraventricular tachycardia in infants. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Disease in Childhood
Subject: Health
ISSN: 0003-9888
Year: 1990
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Fetal and infantile hypertension caused by unilateral renal arterial disease
Article Abstract:
Severe heart failure is a complication of systemic hypertension (high blood pressure) in newborns and young children. Heart failure in three children due to severe hypertension caused by disease of a renal (kidney) artery is described. Two children with heart failure failed to thrive because of unrecognized hypertension. A third child had persistent fetal circulation and heart failure. The hypertension in this child developed in utero, a situation that has not previously been reported. All three children underwent unilateral nephrectomy, i.e. removal of one kidney, to cure their hypertension. These three children were successfully treated, thriving, and doing well at follow-up. The most common causes of neonatal hypertension are stenosis (narrowing) of the renal artery and renal artery thrombosis (blockage due to a clot) or embolization following umbilical arterial catheterization. Failure to thrive and acute or chronic heart failure commonly occur in neonates and young children; however, blood pressure is not routinely measured. Early detection is essential and routine measurement of blood pressure is recommended in all children who fail to thrive, since hypertension is underdiagnosed among these patients. Children with disease of the blood vessels in both kidneys require lifelong drug treatment. In patients with disease of one kidney, unilateral nephrectomy avoids the need for lifelong treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Disease in Childhood
Subject: Health
ISSN: 0003-9888
Year: 1990
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Neurodevelopmental outcome of transient neonatal intracerebral echodensities
Article Abstract:
Periventricular leucomalacia is an abnormal condition involving the development of cysts or sac-like lesions in areas around the cerebral ventricles, or brain cavities. These cysts may result from areas of ischemia (insufficient blood supply). The ischemic areas appear as periventricular echodensities or flares, which are detected by ultrasound, a diagnostic method in which sound waves are used to visualize internal structures. Studies suggest that these echodensities may be associated with impaired neurological function, and infants with these lesions typically develop moderate to severe neurological complications. The development of the neurological system was assessed in 15 infants who had isolated and transient intracerebral flares detected during the neonatal, or newborn, period. These infants did not have evidence of intraventricular bleeding (bleeding into the brain cavities) or cystic degeneration, the deterioration of brain tissue associated with the formation of cysts. Four infants had defects in neurological development, including two with spastic diplegia, a birth-related spastic stiffness of the limbs. The results suggest that transient flares may indicate mild periventricular leucomalacia associated with mild impairment of neurological function. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Disease in Childhood
Subject: Health
ISSN: 0003-9888
Year: 1990
User Contributions:
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