Case Study

An 14 years old female came into the ER

complaining of sudden onset of dizziness,

palpitations, sweating and blurred vision. She

had cold, clammy skin and pallor. Vital signs

were HR = 188 bpm; BP =100/60 mm Hg;

RR = 24 rpm. Full and equal pulses

She was conscious but anxious

In CPR room

Vital signs were checked again and humidified

oxygen was administered via nasal canulae and I.V.

access was established and ECG monitor was

attached

An 12 leads ECG was done and show the following

SupraVentr icular Tachycardia

Steps we had done

Starting by giving her fluid bolus 500 ml of normal saline

Try to slowing heart rate using vagal maneuver (carotid massage) but no response .

Consulting cardiologist.Then giving Amiodarone 150 mg over 20

min. with ECG monitoring (no available Adenosine)

Patient start to respond to amiodarone after 10 min. on monitor

2nd ECG done and showing

Sinus Tachycardia

Reevaluation

H.R. 148 bpm , BP 110/70 mm Hg , RR 18 rpm

Improved symptoms (sweating ,palpitation, anxiety,

pallor)

No previous similar conditions.

Have no chronic illness

Physical examination had revealed any abnormalities

Out come

Patient referred to CCU

Echocardiography had done and no

structural abnormalities identified

Patient advised to make Electrophysiological

study

Patient had home treatment in form of

Inderal “Propranolol”