A 29-day-old newborn weighing 4,100 kg was taken by her parents to the health center for facial exanthema evaluation.
On exploring his pediatrician he observed tachycardia and tachypnea, checking by pulse oximetry a heart rate of 255 ppm and Sat O2: 97%, so he was referred to the hospital.
So far he tolerated his diet well and had a good gain.
Pregnancy and delivery were normal, with Apgar score 8/9, birth weight of 3,250 g, height of 51.5 cm and head circumference of 31.8 cm. No family history of interest was found.
Upon arrival to the emergency department, the patient presented a good general appearance with good color, tachypnea and subcostal printing, a heart rate higher than 250 beats per minute (ppm) with an O2 Sat of 97%.
A few minutes later, the patient presented worsening of his general condition, coldness and facial acrosis.
The ECG showed a morphology of supraventricular tachycardia with narrow QRS complexes, recurrent P waves and a heart rate of 288 ppm.
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Vagal manoeuvres (ice on the face) were performed without effect, so 1 intravenous bolus (IV) of 50 μg/kg of adenosine was administered without response, and 3 minutes later a second sinus tachycardia was observed.
Since in our environment we have 2 ml Adenocor® ampoules with 6 mg of drug, it was necessary to perform dilutions.
In our case, we took 0.5 ml (1.5 mg) diluted with 14.5 ml of saline solution, setting a concentration of 100 μg/ml.
Therefore, an initial dose of 2 ml (50 μg/kg) is administered and, in the absence of response, a second dose of 4 ml (100 μg/kg).
After the resolution of the tachycardia, the patient is referred to the reference hospital, to the pediatric intensive care unit (PICU) for follow-up and study.
During the following 24 hours, the patient developed a new episode of supraventricular tachycardia also resolved with adenosine, remaining asymptomatic thereafter.
Normal echocardiography was reported.
To date, there has been no recurrence, prophylactic treatment with prophylaxis.
