Pediatric Atrial Ectopic Tachycardia Clinical Presentation

Updated: Sep 19, 2016
  • Author: Shubhayan Sanatani, MD; Chief Editor: Stuart Berger, MD  more...
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Presentation

History

Although atrial ectopic tachycardia (AET) is occasionally encountered in patients following surgery for congenital heart disease, most patients have structurally normal hearts and are symptomatic. Palpitations, chest pain, lightheadedness, presyncope, and dyspnea are the most common symptoms.

Asymptomatic or preverbal patients may be noted to be tachycardic or dyspneic on routine evaluation. Difficulty feeding or diaphoresis may accompany the tachycardia in infants.

Exercise intolerance and heart failure are late manifestations of secondary cardiac dysfunction.

The history must be sufficiently broad to rule out causes of persistently elevated heart rates, such as hyperthyroidism, anemia, or catecholamine-producing malignancy. The family history is rarely positive for atrial ectopic tachycardia.

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Physical Examination

The heart rate is inappropriately elevated for the degree of activity. If second-degree atrioventricular (AV) block is present, the heart rate may be irregular. The patient may be tachypneic. In advanced cardiomyopathy, pulses and perfusion are poor, and evidence of cardiac enlargement is present. Hepatic and pulmonary congestion may be present.

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