Paeds Cases · cardiology
Explain supraventricular tachycardia to a frightened parent — OSCE
OSCE communication and shared-planning station: explaining the diagnosis of supraventricular tachycardia to a parent after acute termination in an infant, the long-term medication plan, the expected natural history, and what to watch for at home, with empathy, honesty and without overpromising.
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You are the paediatric registrar. You have five minutes to speak with Mrs Patel, whose four-month-old son Arjun was admitted an hour ago after going pale, floppy, and breathing fast. The team gave him adenosine and his heart rate came down from 250 to a normal 130 within seconds. The echocardiogram shows a structurally normal heart, and the post-termination ECG shows no Wolff-Parkinson-White pattern. Mrs Patel watched the episode at home and is terrified. Explain what supraventricular tachycardia is in plain language, what happened to Arjun, what the medication is for and how long he will need it, what to watch for at home, and the long-term outlook. Answer her questions, check her understanding, and agree a plan. [1]
References4ShowHide
- [1]Brugada J, Blom N, Sarquella-Brugada G, et al. Pharmacological and non-pharmacological therapy for arrhythmias in the pediatric population: EHRA and AEPC-Arrhythmia Working Group joint consensus statement Europace, 2013.PMID 23851511
- [2]Wei N, Lamba A, Franciosi S, et al. Medical Management of Infants With Supraventricular Tachycardia: Results From a Registry and Review of the Literature CJC Pediatr Congenit Heart Dis, 2022.PMID 37969556
- [3]Page RL, Joglar JA, Caldwell MA, et al. 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society J Am Coll Cardiol, 2016.PMID 26409259
- [4]Cohen MI, Triedman JK, Cannon BC, et al. PACES/HRS expert consensus statement on the management of the asymptomatic young patient with a Wolff-Parkinson-White (WPW, ventricular preexcitation) electrocardiographic pattern: developed in partnership between the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Endorsed by the governing bodies of PACES, HRS, the American College of Cardiology Foundation (ACCF), the American Heart Association (AHA), the American Academy of Pediatrics (AAP), and the Canadian Heart Rhythm Society (CHRS) Heart Rhythm, 2012.PMID 22579340