Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Division of Cardiology, Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, Ohio.
J Emerg Med. 2021 Apr;60(4):e89-e94. doi: 10.1016/j.jemermed.2020.12.011. Epub 2021 Jan 21.
Accelerated idioventricular rhythm (AIVR) is an uncommon and typically benign dysrhythmia with similarities to more malignant forms of ventricular tachycardia (VT). It is often seen in adults after myocardial infarctions, although it also arises in the newborn period, as well as in children with and without congenital heart disease.
We describe a presentation of AIVR in an otherwise healthy 13-year-old girl, discovered on arrival to the pediatric emergency department in the setting of post-tonsillectomy bleeding. The case reviews the diagnostic criteria of AIVR, associated symptoms, the pathophysiologic origin of AIVR, and potential treatment strategies. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Given its morphologic similarities to life-threatening forms of VT, AIVR can be misdiagnosed in the emergency department or primary care settings. With an understanding of the dysrhythmia's unique features, emergency physicians can avoid unnecessary interventions and provide the correct diagnosis, workup, and management of AIVR for pediatric patients.
加速性室性自主节律（AIVR）是一种不常见且通常良性的心律失常，与更恶性的室性心动过速（VT）形式相似。它通常发生在心肌梗死后的成年人中，但也会在新生儿期以及患有和不患有先天性心脏病的儿童中出现。
我们描述了一名原本健康的 13 岁女孩在扁桃体切除术后出血的情况下出现 AIVR 的表现，该女孩在儿科急诊室就诊时被发现。该病例回顾了 AIVR 的诊断标准、相关症状、AIVR 的病理生理起源以及潜在的治疗策略。
为什么急诊医生应该了解这个？：由于其形态与危及生命的 VT 形式相似，AIVR 在急诊科或初级保健环境中可能会被误诊。了解心律失常的独特特征，急诊医生可以避免不必要的干预，并为儿科患者提供正确的诊断、检查和 AIVR 管理。
