Patient's question:
Director Fang, my daughter is 14 years old. About five years ago, her second episode of heart palpitations was diagnosed as normal through an echocardiogram. It was said that it might be due to her reading some horror novels and being frightened, which was attributed to psychological factors. In the following two years, she occasionally experienced recurrence, each time lasting only for a short while with accelerated heartbeat, which she didn't pay much attention to. Last week, during class, it recurred again, this time lasting nearly 30 minutes. She said it felt more severe, as if her heart were about to jump out of her throat, with rapid breathing and difficulty speaking. This morning, the hospital diagnosed it as supraventricular tachycardia (or dual/multiple pathways, with something about accessory pathways, etc.), but the exact number of pathways was not yet determined. During a thorough examination, an esophageal catheter was used to stimulate the heart, followed by epinephrine, which quickly brought her heart rate back to 170 and then stabilized on her own. She mentioned that at school, her heart rate was even faster than 170. The doctor said that surgery would eventually be necessary, but for now, it could be managed without intervention, and surgery should be considered only if the episodes recur frequently and last for a long duration. I would like to consult you—could a prolonged episode of tachycardia lead to serious consequences? I have an electrocardiogram report, but it's not with me right now. I'm very anxious and forgot to bring it.Doctor's answer:
According to the description, it should be paroxysmal supraventricular tachycardia, a sudden type of arrhythmia. When it recurs, it may cause palpitations and chest tightness, but it generally does not interfere with hemodynamics and does not cause severe symptoms. If conditions permit, early radiofrequency ablation can be performed to treat it. The child should avoid excessive emotional fluctuations and overly intense exercise.