This post is an answer to the ECG Case 324
- Rate: 150 bpm
- Rhythm:
- Regular narrow complex
- SVT with retrograde atrial activity within QRS-T segment
- Axis: Normal (-33 deg)
- Intervals: QRS – Normal
- Additional:
- Retrograde P waves visible in all leads with QRS-T
- Inverted in leads II, III, aVF
- High voltages in all leads
- At upper limit of normal for age
- Retrograde P waves visible in all leads with QRS-T
Interpretation
- Regular narrow complex tachycardia
- Retrograde P waves
Differential Diagnosis
- AVNRT (Fast-Slow)
- Accelerated junctional tachycardia
- AVRT
What happened next ?
The patient reverted following vagal maneuvers and pediatric cardiology follow-up was arranged in addition to echo. The management of SVT in children and adults should follow as step-wise process whilst simultaneously assessing and treating potential causative factors.
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