Abstract 20343: Usefulness of Echocardiography in Children and Adolescents With New Onset Supraventricular Tachycardia
Introduction: Supraventricular tachycardia (SVT) is the most common sustained arrhythmia in children. Patients with SVT and Wolff-Parkinson-White (WPW) are known to have 10-30% incidence of congenital heart disease (CHD). Infants without WPW who present with SVT under 1 year of age have a similar incidence of CHD. However, for children without WPW who present with SVT at older ages, the incidence of CHD is not known. This study aims to determine the incidence of CHD in older children and adolescents who present with SVT without WPW.
Methods: Children aged 5 to 18 years who presented to our institution with confirmed SVT between January 2011 and December 2015 were included in this retrospective review. Patients with any history of ventricular pre-excitation or pre-existing heart disease were excluded.
Results: There were 290 patients who met inclusion criteria. Echocardiograms were completed on 226 patients, and were included in the study. Only 3 patients had significant echocardiographic findings; 2 patients had systolic dysfunction, and 1 patient had an atrial septal defect. All 3 patients had abnormal physical exam or electrocardiogram (EKG) findings. No significant CHD was identified in any of the remaining patients. Minor anomalies were noted in 25 patients (11%), and included trivial to mild mitral valve regurgitation, mild tricuspid valve regurgitation, mild pulmonary valve regurgitation, trivial aortic insufficiency, left superior vena cava, small coronary fistula, abnormal aortic branching, borderline aortic root dilation, low normal function, and mild left ventricular hypertrophy (LVH). Follow up echocardiograms were performed for 10 of the 25 patients with minor anomalies (40%). Of those patients with additional imaging, 7 with minor anomalies had normalized, 2 remained stable, and only 1 new finding was noted (mild LVH).
Conclusions: No significant CHD was identified in this cohort of children ages 5 to 18 years with SVT without ventricular pre-excitation. All significant abnormal echocardiogram findings were also associated with abnormal physical exam or EKG findings. For older children and adolescents presenting with SVT without WPW, echocardiogram may not be a necessary part of evaluation when physical exam and EKG are normal.
Author Disclosures: K. L’Italien: None. S. Conlon: None. T. Ackley: None. N. Kertesz: None. A. Kamp: None.
- © 2016 by American Heart Association, Inc.