Supraventricular tachycardias [SVTs] in a university] children's hospital emergency department: a 3-year experience

ABSTRACT

In a 3-year retrospective review of 3780 patients who were treated in a University Children's Hospital [ED] along a 3 yr period, 90% were medical cases and 10% were surgical. Admissions due to cardiac diseases represented 20% of all medical cases. During the period of the study there were 55 cases of SVT, representing 1.5% of all admissions and 8.5% of admitted cardiac cases. They were 38 males and 17 females in the age range of 18 days to 12 years. There was a significant predominance of male sex [male female 2.21; P = 0.029]. Age distribution showed that PSVT mainly affected infants more than children, with a mean age of 1.7 yr [P = 0.01]. Among the PSVT patients 3 cases [5.5%] had an underlying cardiac disease while the remaining had lone arrhythmia. In 100%, clinical examination and ECG were diagnostic. Out of all study group, 48 cases [87%] were referred from outpatients clinics while only 7 cases [13%] were referred from inpatient departments of community secondary hospitals. Most referrals were from outpatients [P = 0.02]. The highest admission rates were recorded in summer months and early winter than during spring and fall [P = 0.013]. Appropriate treatment with vagal stimulation, medical treatment, or synchronized DC cardio-version was applied as indicated. In this study 51 patients [92.7%] were able to be discharged to their homes after a mean duration of 2-5 days' hospitalization, while 4 patients [7.3%] died. Two cases died within 24 hours, and other 2 died within 48 hours. Mortality from PSVT after 24 hours of admission represented 0.4% of total mortality of ED admissions. Bad prognosis was associated with younger age, male sex, outpatient referrals and presence of heart failure at presentation