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Pediatric ECGs: Difference between revisions
→Distinguishing tachyarrhythmias in infants
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{| class="wikitable" font-size="80%" width="100%" style="border:1px solid #E2ACB1;border-spacing:8px;" border="1" | {| class="wikitable" font-size="80%" width="100%" style="border:1px solid #E2ACB1;border-spacing:8px;" border="1" | ||
|+ Distinguishing tachyarrhythmias in infants | |+ Distinguishing tachyarrhythmias in infants | ||
! | ! style="width:80px" | | ||
! Sinus tachycardia | ! style="width:200px" | Sinus tachycardia | ||
! SVT | ! style="width:200px" | SVT | ||
! Atrial flutter | ! style="width:200px" | Atrial flutter | ||
! VT | ! style="width:200px" | VT | ||
|- | |- | ||
| History | | valign="top" | History | ||
| Sepsis, fever, hypovolaemia, etc. | | valign="top" | Sepsis, fever, hypovolaemia, etc. | ||
| Usually otherwise normal | | valign="top" | Usually otherwise normal | ||
| Most have a normal heart | | valign="top" | Most have a normal heart | ||
| Many with abnormal heart | | valign="top" | Many with abnormal heart | ||
|- | |- | ||
| Rate | | valign="top" | Rate | ||
| Almost always <230 b/min | | valign="top" | Almost always <230 b/min | ||
| Most often 260–300 b/min | | valign="top" | Most often 260–300 b/min | ||
| Atrial 300–500 b/min. Vent. 1:1 to 4:1 conduction | | valign="top" | Atrial 300–500 b/min. Vent. 1:1 to 4:1 conduction | ||
| 200–500 b/min | | valign="top" | 200–500 b/min | ||
|- | |- | ||
| R-R interval variation | | valign="top" | R-R interval variation | ||
| Over several seconds may get faster and slower | | valign="top" | Over several seconds may get faster and slower | ||
| After first 10–20 beats, extremely regular | | valign="top" | After first 10–20 beats, extremely regular | ||
| May have variable block (1:1, 2:1, 3:1) giving different ventricular rates | | valign="top" | May have variable block (1:1, 2:1, 3:1) giving different ventricular rates | ||
| Slight variation over several beats | | valign="top" | Slight variation over several beats | ||
|- | |- | ||
| P wave axis | | valign="top" | P wave axis | ||
| Same as sinus almost always visible P waves | | valign="top" | Same as sinus almost always visible P waves | ||
| 60% visible P waves, P waves <em>do not</em> look like sinus P waves | | valign="top" | 60% visible P waves, P waves <em>do not</em> look like sinus P waves | ||
| Flutter waves (best seen in LII, LIII, aVF, V<sub>1</sub>) | | valign="top" | Flutter waves (best seen in LII, LIII, aVF, V<sub>1</sub>) | ||
| May have sinus P waves continuing unrelated to VT (AV dissociation), retrograde P waves, or no visible P waves | | valign="top" | May have sinus P waves continuing unrelated to VT (AV dissociation), retrograde P waves, or no visible P waves | ||
|- | |- | ||
| QRS | | valign="top" | QRS | ||
| Almost always same as slower sinus rhythm | | valign="top" | Almost always same as slower sinus rhythm | ||
| After first 10–20 beats, almost always same as sinus | | valign="top" | After first 10–20 beats, almost always same as sinus | ||
| Usually same as sinus, may have occasional beats different from sinus | | valign="top" | Usually same as sinus, may have occasional beats different from sinus | ||
| Different from sinus (<em>not</em> necessarily ‘wide’) | | valign="top" | Different from sinus (<em>not</em> necessarily ‘wide’) | ||
|- | |- | ||