Pediatric Cardiology Part 1: The Haywire Heart

As Gloria Estefan would say, “The rhythm is gonna get ya!” Children presenting in an abnormal rhythm can cause palpitations for everyone involved. In a crisis, you can always fall back on PALS/ACLS since algorithms are for doing and not thinking. But if you have time to think, a better understanding of the dysrhythmia will help you stay calm and speak intelligently with your cardiology and critical care colleagues.

EKG Examples:

SVT in a 16 year old with palpiations.

Infant SVT in a 6-month-old presenting with heart failure from tachycardia mediated cardiomyopathy.

A 21 day old with variable block 4:3 atrial flutter – super rare, but a reminder not to be afraid of electricity.

An 18-year-old with polymorphic ventricular tachycardia – note the capture beat as a sign of AV dissociation.