Projectile vomiting and Valsalva-like abdominal contractions as an uncommon presentation of supraventricular tachycardia in an infant

Roberto Paparella; Saverio Mallardo; Riccardo Lubrano

doi:10.1016/j.jelectrocard.2021.04.010

Projectile vomiting and Valsalva-like abdominal contractions as an uncommon presentation of supraventricular tachycardia in an infant

J Electrocardiol. 2021 May-Jun:66:136-138. doi: 10.1016/j.jelectrocard.2021.04.010. Epub 2021 Apr 22.

Authors

Roberto Paparella¹, Saverio Mallardo², Riccardo Lubrano²

Affiliations

¹ Department of Maternal and Child Health and Urology, Sapienza University of Rome, Rome, Italy. Electronic address: [email protected].
² Department of Maternal and Child Health, "Santa Maria Goretti" Hospital, Sapienza University of Rome, Latina, Italy.

PMID: 33957501
DOI: 10.1016/j.jelectrocard.2021.04.010

Abstract

Paroxysmal supraventricular tachycardia (PSVT) is a prevalent pediatric arrhythmia. Neonatal and infantile-onset presentation is unspecific, thus making differential diagnosis essential in not delaying crucial intervention. We here describe the case of an undetected PSVT in an infant performing repeated abdominal contractions, thus presenting with projectile vomiting. At an early stage of tachycardia, infants are probably able to unconsciously attempt and succeed to terminate acute episodes by strengthening vagal stimulation in the form of Valsalva-like abdominal contractions, but only up to a point. As PSVT progresses, heart failure may develop. Early recognition and treatment are therefore required to minimize negative outcomes.

Keywords: Projectile vomiting; Supraventricular tachycardia; Valsalva maneuver.

Publication types

Case Reports

MeSH terms

Child
Electrocardiography
Humans
Infant
Infant, Newborn
Tachycardia, Paroxysmal*
Tachycardia, Supraventricular* / diagnosis
Tachycardia, Ventricular*
Vomiting / etiology