Arrhythmias in Children: A Case-Based Approach

Description:

Pediatric arrhythmias present numerous challenges to pediatric cardiologists and other practitioners who see pediatric patients, including pediatricians, family physicians, emergency physicians, residents, fellows, and other clinicians. Arrhythmias in Children: A Case-Based Approach features practical methods for diagnosing and treating arrhythmias in these patients across all settings. Nearly three dozen real-world scenarios are presented, followed by a discussion of the diagnosis, clinical thinking process involved, treatment options, expected outcomes, and how to manage anticipated and unanticipated outcomes. These practical, realistic cases provide a unique and engaging way of approaching these challenging patient scenarios. 

Table Of Contents:

1. Newborn/Infant
   1. Newborn nursery infant that has bradycardia
      1. What am I thinking about?
      2. History and Physical
      3. Differential Diagnosis
         1. Fetus with premature beats
         2. Newborn with complete heart block
         3. Hypothyroidism
         4. Medication-induced
         5. Apnea
      4. Tests to Order
      5. Practical Plan of Action
   2. NICU infant noted to have extrasystoles on cardiac monitor
   3. Full-term infant noted to have persistent tachycardia
   4. 2-month-old presenting to the ER with tachycardia, fussy, unable to eat
   5. 4-month-old with extrasystoles on auscultation at pediatrician’s office
   6. 9-month-old with recurrent episodes of supraventricular tachycardia despite medical therapy
2. Child
   1. 2-year-old presents to ER with an episode of "passing out" and "turning blue"
   2. 3-year-old is noted by pediatrician to have a low resting heart rate
   3. 4-year-old presents to ER with supraventricular tachycardia
   4. 7-year-old presents to ER with recurrent SVT
   5. 8-year-old presents with ADHD presents to cardiology office with ECG in hand for "cardiac clearance" to start stimulants
   6. 10-year-old presents to ER with dizziness and bradycardia with a pacemaker that does not appear to be functioning
   7. 11-year-old whose father recently died at the age of 45
   8. 5-year-old, asymptomatic, with ECG obtained for physical demonstrating WPW
3. Pre-teen/Teenager
   1. 13-year-old with syncope while standing in line for lunch
   2. 15-year-old with intentional ingestion of grandparent’s calcium channel blockers
   3. 16-year-old with premature ventricular contractions noted during athletic participation physical.
   4. 14-year-old cross country runner presents with syncope during a race
   5. 15-year-old with syncope while playing soccer
   6. 17-year-old with palpitations and dizziness while playing football
   7. 14-year-old who had to be pulled from the pool during a swim meet
4. Special Circumstances
   1. Maternal fetal evaluation reveals fetus with tachycardia
   2. Maternal fetal evaluation reveals fetus with premature beats
   3. A newborn infant with complete heart block noted immediately after birth
   4. A 3-month old child with complete heart block after surgery for AV canal defect
   5. A 4-month old post-operative ventricular septal defect with junctional ectopic tachycardia
   6. A 2-year old child who took an overdose of grandmother’s digoxin pills
   7. A 10-year old child with a "pacemaker" who is dizzy and had a syncope episode
   8. An 11-year old child resuscitated from sudden collapse, found to have a long QT on ECG
   9. A 12-year old with hypertrophic cardiomyopathy presents to the emergency room with syncope
   10. A 13-year old with repaired tetralogy of Fallot with frequent PVCs
   11. A 15-year old presents to ER after successful resuscitation with an AED for documented ventricular fibrillation
   12. A 16-year old teen with a defibrillator who received a shock