Garson A
Pediatrics. 1987 Jan;79(1):84-8.
Malpractice actions against pediatricians treating patients with arrhythmias have been recurrent in four general areas. Optimal medical management may not be widely recognized. Cases illustrating the following concepts are presented. Intravenous verapamil therapy in babies may cause apnea, hypotension, and bradycardia; continued episodes of atrial flutter in a child may cause sudden death; quinidine may be related to the death; children with "familial seizure disorders" may in fact have the long QT interval syndrome. The QT interval must be measured on the ECG in patients with unexplained seizures; "supraventricular tachycardia with aberration" is uncommon in children. Rapid heart rates with QRS complexes that are different from the sinus complexes are likely to be ventricular tachycardia. These situations must be recognized as potential problems and must be treated appropriately.
针对治疗心律失常患儿的儿科医生的医疗事故诉讼主要集中在四个常见领域。最佳医疗管理可能未得到广泛认可。以下将列举说明这些概念的案例。婴儿静脉注射维拉帕米治疗可能导致呼吸暂停、低血压和心动过缓；儿童持续性心房扑动可能导致猝死；奎尼丁可能与死亡有关；患有“家族性癫痫症”的儿童实际上可能患有长QT间期综合征。对于不明原因癫痫发作的患者，必须在心电图上测量QT间期；“伴有差异传导的室上性心动过速”在儿童中并不常见。QRS波群快速心率与窦性波群不同时，很可能是室性心动过速。必须认识到这些情况是潜在问题，并进行适当治疗。
