Haas N A, Pufahl C, König S A, Gessler P, Teufel M
Universitäts-Kinderklinik, Fakultät für klinische Medizin Mannheim, Universität Heidelberg.
Dtsch Med Wochenschr. 1994 Oct 7;119(40):1351-6. doi: 10.1055/s-2008-1058845.
A previously healthy and normally developing 12-day-old female suddenly became restless and developed cold sweats, tachypnoea and tachycardia (300 beats/min). Neither electrocardiogram nor echocardiogram showed evidence of any cardiac defect. Carotid sinus massage and other vagus-stimulating manoeuvres, undertaken because paroxysmal supraventricular tachycardia (PSVT) was suspected, were unsuccessful. Before rapid digitalization, adenosine triphosphate was administered (0.1 mg/kg intravenously). Sinus rhythm was restored within about 60 s. Despite further treatment with digoxin and verapamil (4 mg/kg.d), further episodes of PSVT occurred, each again responding to ATP (0.1 to 0.3 mg/kg). There were no side effects. After 24-hour Holter ECG monitoring had revealed Wolff-Parkinson-White syndrome as cause of the PSVT, propafenone was administered (15 mg/kg daily) and has prevented further recurrence of the tachycardia.
一名此前健康且发育正常的12日龄女婴突然变得烦躁不安,出现冷汗、呼吸急促和心动过速(300次/分钟)。心电图和超声心动图均未显示任何心脏缺陷的迹象。由于怀疑是阵发性室上性心动过速(PSVT),进行了颈动脉窦按摩和其他刺激迷走神经的操作,但未成功。在快速洋地黄化之前,静脉注射了三磷酸腺苷(0.1毫克/千克)。约60秒内恢复了窦性心律。尽管用地高辛和维拉帕米(4毫克/千克·天)进一步治疗,但仍再次发生PSVT发作,每次发作再次对ATP(0.1至0.3毫克/千克)有反应。未出现副作用。24小时动态心电图监测显示WPW综合征是PSVT的病因后,给予普罗帕酮(每日15毫克/千克),并防止了心动过速的进一步复发。