Auricular Paroxysmal Tachycardia in an Infant

Abstract

Important disturbances of cardiac rhythm are uncommon in infancy, but one which occurs occasionally is auricular paroxysmal tachycardia. The attacks of tachycardia usually develop suddenly and are characterized by a regular rhythm at an extremely rapid rate. The paroxysms generally last for a few minutes to several hours, and the reestablishment of normal rhythm is, as a rule, abrupt. Many attacks terminate spontaneously or as the result of vomiting, while others can be brought to an end by pressure on the carotid sinus. It is only rarely that drug therapy is necessary. The present case is reported because of the long duration of the attack, its systemic effect on the patient, and the difficulties encountered in restoring normal rhythm.

CASE REPORT

The patient, a white boy 12 months of age, was admitted to the hospital on August 11, 1940 because of refusal to eat, diarrhea, loss of weight and tachycardia. Diarrhea, refusal to eat and occasional vomiting had developed about five weeks earlier, and after these symptoms had been present for ten days or two weeks, it was noted that the heart rate was extremely rapid. The tachycardia had persisted until the present without interruption. The infant refused practically all of his feedings and whenever he did take even a small amount, a considerable part of this was promptly regurgitated. The diarrhea, however, had improved gradually although at the time of admission there were still two to five movements each day. The body weight had decreased from 25 pounds at. . .