Tatalaksana komprehensif pada supraventricular tachycardia (SVT) anak dengan riwayat kardiomiopati dilatasi : Laporan kasus dan telaah pustaka

Luh Made Indrasuari; Sari Linda Silvana

doi:10.15562/ism.v14i1.1595

Tatalaksana komprehensif pada supraventricular tachycardia (SVT) anak dengan riwayat kardiomiopati dilatasi : Laporan kasus dan telaah pustaka

Luh Made Indrasuari ,

Sari Linda Silvana ,

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DOI: https://doi.org/10.15562/ism.v14i1.1595 |
Published: 2023-04-09

Abstract

Introduction: Supraventricular tachycardia (SVT) is one of the children's most common heart rhythm abnormalities. Episodes of SVT attacks in children are often recurring and, if not properly recognized, can be life-threatening. This case reports the incidence of SVT in children and its management, supported by a literature review

Case Description: A 1-year-old boy came to the hospital complaining of palpitations accompanied by an increase in carotid pulse and cold sweat 30 minutes before entering the hospital. The patient has a history of dilated cardiomyopathy and had the same complaint at the age of 6 months. On physical examination, blood pressure was 197/68 mmHg, pulse 235x/m, respiratory rate 32x/m accompanied by cold acral. The EKG showed SVT. Initial non-pharmacological management is carried out with vagal maneuvers, namely circular massage in the carotid sinus area for 10 seconds, followed by ice packs for 10 seconds. Then pharmacological cardioversion with amiodarone was carried out and continued with amiodarone maintenance therapy and treatment in the PICU room, as well as chest X-ray investigations and echocardiography.

Conclusion: Diagnosis of SVT is based on a detailed history and physical examination. EKG and echocardiography should be performed in children suspected of having SVT. Successful elimination of SVT results in improved quality of life in pediatrics regarding physical, emotional, social, school and psychosocial functioning.

Pendahuluan : Supraventricular tachycardia (SVT) merupakan salah satu kelainan irama jantung yang paling sering muncul pada anak. Episode serangan SVT pada anak sering berulang dan jika tidak dikenali dengan baik dapat mengancam nyawa. Kasus ini melaporkan kejadian SVT pada anak serta manajemen yang dilakukan dengan ditunjang telaah pustaka

Laporan Kasus : Laki-laki usia 1 tahun datang ke ke rumah sakit dengan keluhan berdebar disertai peningkatan pulsasi nadi karotis dan keringat dingin sejak 30 menit sebelum masuk rumah sakit. Pasien memiliki riwayat kardiomiopati dilatasi dan sempat mengalami keluhan yang sama pada usia 6 bulan. Pada pemeriksaan fisik didapatkan tensi 97/68 mmHg, nadi 235x/m, laju napas 32x/m disertai dengan akral dingin. Pada EKG ditemukan gambaran SVT. Tatalaksana awal non-farmakologi dilakukan dengan vagal manuver yaitu pemijatan sirkular di area sinus karotis selama 10 detik dan dilanjutkan dengan kompres es selama 10 detik. Dilakukan kardioversi farmakologis dengan amiodaron dan dilanjutkan terapi rumatan amiodaron. Dilakukan pemeriksaan penunjang rontgen thorax dan echocardiografi pada pasien.

Kesimpulan : Untuk menegakkan diagnosis SVT, anamnesis terperinci dan pemeriksaan fisik sangat penting untuk dilakukan. EKG dan ekokardiografi harus dilakukan pada anak yang diduga menderita SVT. Keberhasilan eliminasi SVT menghasilkan peningkatan kualitas hidup pediatrik mengenai fungsi fisik, emosional, sosial, sekolah dan psikososial.

References

Salerno JC, Seslar SP. Supraventricular tachycardia. Vol. 163, Archives of Pediatrics and Adolescent Medicine. 2009.
Clausen H, Theophilos T, Jackno K, Babl FE. Paediatric arrhythmias in the emergency department. Emerg Med J. 2012;29(9).
Wu MH, Chen HC, Kao FY, Huang SK. Postnatal cumulative incidence of supraventricular tachycardia in a general pediatric population: A national birth cohort database study. Hear Rhythm. 2016;13(10).
Abo Hadeed HM. Diagnosis and Treatment of Supraventricular Tachyarrhythmia in Pediatric Population: a Review Article. Acad J Pediatr Neonatol. 2017;2(4).
Hafez MM, Abu-Elkheir MM, Shokier M, Al-Marsafawy HF, Abo-Haded HM, Abo El-Maaty M. Radiofrequency catheter ablation in children with supraventricular tachycardias: Intermediate term follow up results. Clin Med Insights Cardiol. 2012;6.
Quattrocelli A, Lang J, Davis A, Pflaumer A. Age makes a difference: symptoms in pediatric supraventricular tachycardia. J Arrhythmia. 2018;34(5).
Spearman AD, Williams P. Supraventricular tachycardia in infancy and childhood. Pediatr Ann. 2014;43(11).
Balaguer Gargallo M, Jordán García I, Caritg Bosch J, Cambra Lasaosa FJ, Prada Hermogenes F, Palomaque Rico A. Taquicardia paroxística supraventricular en el niño y el lactante. An Pediatr. 2007;67(2).
Trappe Gianfranco Mazzotta H-J, Carlos Araujo Morais J, Oto A, Smiseth O, Angeles Alonso Garcia M, Klein WW, et al. Committee for Practice Guidelines Members. J Am Coll Cardiol. 2003;42.
Doniger SJ, Sharieff GQ. Pediatric dysrhythmias. Vol. 53, Pediatric Clinics of North America. 2006.
Snyder CS, Fenrich AL, Friedman RA, Rosenthal G, Kertesz NJ. Usefulness of echocardiography in infants with supraventricular tachycardia. Am J Cardiol. 2003;91(10).
Melton PE, Zlojutro M, Kimminau K, Crawford MH. Biological aging and cox hazard analysis of mortality trends in a Mennonite community from South-Central Kansas. Am J Hum Biol. 2006;18(3).
Emmel M, Sreeram N, Schickendantz S, Brockmeier K. Experience with an ambulatory 12-lead Holter recording system for evaluation of pediatric dysrhythmias. J Electrocardiol. 2006;39(2).
Schlechte EA, Boramanand N, Funk M. Supraventricular Tachycardia in the Pediatric Primary Care Setting: Age-related Presentation, Diagnosis, and Management. J Pediatr Heal Care. 2008;22(5).
Lee KW, Badhwar N, Scheinman MM. Supraventricular Tachycardia-Part II: History, Presentation, Mechanism, and Treatment. Curr Probl Cardiol. 2008;33(10).
Van Hare GF, Javitz H, Carmelli D, Saul JP, Tanel RE, Fischbach PS, et al. Prospective assessment after pediatric cardiac ablation: Demographics, medical profiles, and initial outcomes. J Cardiovasc Electrophysiol. 2004;15(7).
Strieper M, Leong T, Bajaj T, Huckaby J, Frias P, Campbell R. Does ablation of supraventricular tachycardia in children with a structurally normal heart improve quality of life? Congenit Heart Dis. 2010;5(6).

[1] Salerno JC, Seslar SP. Supraventricular tachycardia. Vol. 163, Archives of Pediatrics and Adolescent Medicine. 2009.

[2] Clausen H, Theophilos T, Jackno K, Babl FE. Paediatric arrhythmias in the emergency department. Emerg Med J. 2012;29(9).

[3] Wu MH, Chen HC, Kao FY, Huang SK. Postnatal cumulative incidence of supraventricular tachycardia in a general pediatric population: A national birth cohort database study. Hear Rhythm. 2016;13(10).

[4] Abo Hadeed HM. Diagnosis and Treatment of Supraventricular Tachyarrhythmia in Pediatric Population: a Review Article. Acad J Pediatr Neonatol. 2017;2(4).

[5] Hafez MM, Abu-Elkheir MM, Shokier M, Al-Marsafawy HF, Abo-Haded HM, Abo El-Maaty M. Radiofrequency catheter ablation in children with supraventricular tachycardias: Intermediate term follow up results. Clin Med Insights Cardiol. 2012;6.

[6] Quattrocelli A, Lang J, Davis A, Pflaumer A. Age makes a difference: symptoms in pediatric supraventricular tachycardia. J Arrhythmia. 2018;34(5).

[7] Spearman AD, Williams P. Supraventricular tachycardia in infancy and childhood. Pediatr Ann. 2014;43(11).

[8] Balaguer Gargallo M, Jordán García I, Caritg Bosch J, Cambra Lasaosa FJ, Prada Hermogenes F, Palomaque Rico A. Taquicardia paroxística supraventricular en el niño y el lactante. An Pediatr. 2007;67(2).

[9] Trappe Gianfranco Mazzotta H-J, Carlos Araujo Morais J, Oto A, Smiseth O, Angeles Alonso Garcia M, Klein WW, et al. Committee for Practice Guidelines Members. J Am Coll Cardiol. 2003;42.

[10] Doniger SJ, Sharieff GQ. Pediatric dysrhythmias. Vol. 53, Pediatric Clinics of North America. 2006.

[11] Snyder CS, Fenrich AL, Friedman RA, Rosenthal G, Kertesz NJ. Usefulness of echocardiography in infants with supraventricular tachycardia. Am J Cardiol. 2003;91(10).

[12] Melton PE, Zlojutro M, Kimminau K, Crawford MH. Biological aging and cox hazard analysis of mortality trends in a Mennonite community from South-Central Kansas. Am J Hum Biol. 2006;18(3).

[13] Emmel M, Sreeram N, Schickendantz S, Brockmeier K. Experience with an ambulatory 12-lead Holter recording system for evaluation of pediatric dysrhythmias. J Electrocardiol. 2006;39(2).

[14] Schlechte EA, Boramanand N, Funk M. Supraventricular Tachycardia in the Pediatric Primary Care Setting: Age-related Presentation, Diagnosis, and Management. J Pediatr Heal Care. 2008;22(5).

[15] Lee KW, Badhwar N, Scheinman MM. Supraventricular Tachycardia-Part II: History, Presentation, Mechanism, and Treatment. Curr Probl Cardiol. 2008;33(10).

[16] Van Hare GF, Javitz H, Carmelli D, Saul JP, Tanel RE, Fischbach PS, et al. Prospective assessment after pediatric cardiac ablation: Demographics, medical profiles, and initial outcomes. J Cardiovasc Electrophysiol. 2004;15(7).

[17] Strieper M, Leong T, Bajaj T, Huckaby J, Frias P, Campbell R. Does ablation of supraventricular tachycardia in children with a structurally normal heart improve quality of life? Congenit Heart Dis. 2010;5(6).

Tatalaksana komprehensif pada supraventricular tachycardia (SVT) anak dengan riwayat kardiomiopati dilatasi : Laporan kasus dan telaah pustaka

Abstract

References

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