Wide-complex tachycardia with an unusual response to electrical cardioversion in an adolescent with Chiari 1 malformation: A case report

JEM reports Pub Date : 2025-04-11 DOI:10.1016/j.jemrpt.2025.100167

Jonathan Mohnkern , Laura Williams , Christopher Fullagar

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引用次数: 0

Abstract

Background

Pediatric patients with sustained tachyarrhythmias present unique challenges to prehospital clinicians due to differences in physiology, pathology, compensatory mechanisms, and treatment algorithms. Additionally, pediatric patients require careful thought into the psychosocial impacts that one's demeanor, treatment, and explanations will have on them.

Case report

This case illustrates an adolescent male with a history of Chiari 1 malformation who presented to EMS with sustained monomorphic ventricular tachycardia (VT). An unusual rhythm response was experienced during electrical cardioversion, where this intervention resulted in an immediate doubling of his heart rate.

Why should an emergency physician be aware of this?

We discuss approaches to pediatric dysrhythmias, differential diagnosis considerations, appropriate management of wide-complex tachycardia, and methods to reduce the psychological burden on patients and families in a first-encounter clinical situation.

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宽复性心动过速伴电复律异常反应的青少年Chiari 1畸形：1例报告

背景：由于儿童的生理、病理、代偿机制和治疗方法的差异，持续的快速心律失常给院前临床医生带来了独特的挑战。此外，儿科患者需要仔细考虑一个人的行为、治疗和解释会对他们产生的心理社会影响。病例报告：本病例描述了一名有Chiari 1型畸形史的青少年男性，他以持续的单形态性室性心动过速（VT）就诊于EMS。在电复律期间出现了不寻常的节律反应，这种干预导致他的心率立即加倍。急诊医生为什么要意识到这一点？我们讨论了儿童心律失常的方法，鉴别诊断的考虑，宽复杂性心动过速的适当管理，以及在首次遇到临床情况时减轻患者和家属心理负担的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JEM reports Emergency Medicine

自引率

0.00%

发文量

审稿时长

54 days