Paroxysmal Supraventricular Tachycardia in Infants and Children - Clinical Study of 36 Cases -

摘要

Thirty-six cases of paroxysmal supraventricular tachycardia which were observed at the Department of Pediatrics, Seoul National University Hospital from 1976 till October 1982, were analyzed. 1. The sex ratio was 1.8:1, male predominance. Sixteen cases (44.4%) were under 1 year of age and 11 cases (30.6%) were under 4 months of age. 2. Cases without known heart disease were 22(61.6%). Among Known etiology, most frequent one was 7 cases(19.4%) of W-P-W syndrome. 3. The sex ratio of group without known heart disease was 2.1:1, and that of group with known heart disease was 1.3:1. Under 4 months of age, there were more cases without known heart disease(72.7%) and after 4 months of age number of cases with and without known heart disease were similar. 4. Most frequent clinical manifestation was tachydyspnea. hepatomegly, irritability, palipitation, cyanosis and pallor, vomiting, chest pain, edema, abdominal pain, and fever were followed in order of frequency. 5. Congestive heart failure occurred in 22 cases(61%). The incidence was related to the duration of attack of tachycardia, age of patients, and heart rate. The longer the duration of attack and the younger the age of patients and the faster the heart rate, the higher incidence of heart failure was observed. 6. As treatment, vagal reflex stimulation was almost ineffective, and digitalization was effective in most of the cases. Verapamil and electrical cardioversion were tried in small number of cases and proved to be effective. 7. One case (2.8%) expired becase of the supraventricular tachycardia. 8. Eight cases (30.8%) had recurrence. In younger age group, recurrence rate was lower. 9. Digoxin was given in 15 cases for prevention of recurrence and was effective in 12 cases.