Morley-Smith Edward John, Gagg James, Appelboam Andrew
Emergency Department, Taunton and Somerset NHS Foundation Trust, Taunton, UK.
Emergency Medicine, Musgrove Park Hospital NHS Foundation Trust, Taunton, UK.
BMJ Case Rep. 2017 May 4;2017:bcr2016218083. doi: 10.1136/bcr-2016-218083.
A boy aged 7 years presented with his parents to the emergency department (ED). He had a known diagnosis of paroxysmal supraventricular tachycardia (SVT) and was under the care of paediatricians. He had been suffering episodes of palpitations and chest pain for over a year and had been prescribed atenolol 25 mg ON, though the side effects meant he had not taken it for a month prior to presentation. He had 2 previous confirmed episodes of SVT, one that reverted with Valsalva manoeuvres, and the other with intravenous adenosine. In the ED, an ECG was recorded showing SVT at 180 bpm. Aside from his tachycardia, he was haemodynamically stable. The postural modification of the Valsalva technique was performed within 5 min of arrival, with reversion to sinus rhythm occurring during the leg-lift phase on the first attempt. After 30 min of observation, the child remained stable and was discharged home.
一名7岁男孩随父母前往急诊科就诊。他已知患有阵发性室上性心动过速（SVT），一直在儿科医生的照料下。他出现心悸和胸痛症状已有一年多，之前曾被开了阿替洛尔，每晚服用25毫克，但副作用导致他在就诊前一个月未服用该药。他之前曾有2次确诊的SVT发作，一次通过瓦尔萨尔瓦动作恢复正常心律，另一次通过静脉注射腺苷恢复正常心律。在急诊科，记录的心电图显示室上性心动过速，心率为每分钟180次。除了心动过速外，他的血流动力学稳定。到达后5分钟内进行了瓦尔萨尔瓦技术的体位改变，第一次尝试在抬腿阶段即恢复为窦性心律。经过30分钟的观察，孩子情况稳定，随后出院回家。
