Arrhythmias in Children
A Case-Based Approach

Learn to apply expert clinical thinking skills to pediatric arrhythmia cases

Vincent C. Thomas (Author), Seshadri Balaji (Author)

9780323779074, Elsevier Health Sciences

Paperback / softback, published 15 April 2021

180 pages
23.4 x 19 x 1.3 cm, 0.32 kg

Pediatric arrhythmias present numerous challenges to pediatric cardiologists and other practitioners who see pediatric patients, including pediatricians, family physicians, emergency physicians, residents, fellows, and other clinicians. Arrhythmias in Children: A Case-Based Approach features practical methods for diagnosing and treating arrhythmias in these patients across all settings. Nearly three dozen real-world scenarios are presented, followed by a discussion of the diagnosis, clinical thinking process involved, treatment options, expected outcomes, and how to manage anticipated and unanticipated outcomes. These practical, realistic cases provide a unique and engaging way of approaching these challenging patient scenarios.

• Uses a case-based approach for a full spectrum of pediatric arrythmias in the newborn, child, pre-teen, and teenager.

• Presents history and physical, differential diagnoses, tests to order, and practical plans of action.

• Includes a section on arrythmias in special circumstances.

• Models clinical thinking skills for a wide number of real-world patient situations.

• Reviews pertinent clinical guidelines, treatment, and follow up.

1. Newborn/Infant

1. Newborn nursery infant that has bradycardia

1. What am I thinking about?
2. History and Physical
3. Differential Diagnosis

1. Fetus with premature beats
2. Newborn with complete heart block
3. Hypothyroidism
4. Medication-induced
5. Apnea
4. Tests to Order
5. Practical Plan of Action
2. NICU infant noted to have extrasystoles on cardiac monitor
3. Full-term infant noted to have persistent tachycardia
4. 2-month-old presenting to the ER with tachycardia, fussy, unable to eat
5. 4-month-old with extrasystoles on auscultation at pediatrician’s office
6. 9-month-old with recurrent episodes of supraventricular tachycardia despite medical therapy
2. Child

1. 2-year-old presents to ER with an episode of "passing out" and "turning blue"
2. 3-year-old is noted by pediatrician to have a low resting heart rate
3. 4-year-old presents to ER with supraventricular tachycardia
4. 7-year-old presents to ER with recurrent SVT
5. 8-year-old presents with ADHD presents to cardiology office with ECG in hand for "cardiac clearance" to start stimulants
6. 10-year-old presents to ER with dizziness and bradycardia with a pacemaker that does not appear to be functioning
7. 11-year-old whose father recently died at the age of 45
8. 5-year-old, asymptomatic, with ECG obtained for physical demonstrating WPW
3. Pre-teen/Teenager

1. 13-year-old with syncope while standing in line for lunch
2. 15-year-old with intentional ingestion of grandparent’s calcium channel blockers
3. 16-year-old with premature ventricular contractions noted during athletic participation physical.
4. 14-year-old cross country runner presents with syncope during a race
5. 15-year-old with syncope while playing soccer
6. 17-year-old with palpitations and dizziness while playing football
7. 14-year-old who had to be pulled from the pool during a swim meet
4. Special Circumstances

1. Maternal fetal evaluation reveals fetus with tachycardia
2. Maternal fetal evaluation reveals fetus with premature beats
3. A newborn infant with complete heart block noted immediately after birth
4. A 3-month old child with complete heart block after surgery for AV canal defect
5. A 4-month old post-operative ventricular septal defect with junctional ectopic tachycardia
6. A 2-year old child who took an overdose of grandmother’s digoxin pills
7. A 10-year old child with a "pacemaker" who is dizzy and had a syncope episode
8. An 11-year old child resuscitated from sudden collapse, found to have a long QT on ECG
9. A 12-year old with hypertrophic cardiomyopathy presents to the emergency room with syncope
10. A 13-year old with repaired tetralogy of Fallot with frequent PVCs
11. A 15-year old presents to ER after successful resuscitation with an AED for documented ventricular fibrillation
12. A 16-year old teen with a defibrillator who received a shock

Subject Areas: Paediatric medicine [MJW], Cardiovascular medicine [MJD], Physiology [MFG]