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Approach to the child with tachycardia

Suzan Mazor, MD
Robert Mazor, MD
Section Editors
George A Woodward, MD
Jan E Drutz, MD
Deputy Editor
James F Wiley, II, MD, MPH


Tachycardia is common in the pediatric age group, and the etiology is often benign. A parent or other observer may describe tachycardia based on observation of the child's neck veins, palpation of the pulse, or sensation of the heart beating rapidly while holding the child. All complaints of tachycardia require rapid assessment of patient status and cardiac rhythm. In most instances, life-threatening tachycardia can be rapidly detected and treated. This topic will review the differential diagnosis and approach to the child who presents with tachycardia.


The differential diagnosis of tachycardia in children is provided in the table (table 1).

Life-threatening cardiac conditions — Most life-threatening cardiac conditions in children that present as tachycardia consist of supraventricular tachycardias. However, any type of arrhythmia may occur depending on specific patient predisposition [1].

Supraventricular tachycardia (SVT) – The most common symptomatic dysrhythmia of childhood, SVT may present with palpitations, chest pain, or shortness of breath in children, or with lethargy, feeding difficulties, or irritability in infants. In many instances, a parent or healthcare provider notes a rapid heart rate during routine care. In newborns and infants with SVT, the heart rate is typically >220 beats per minute (BPM), while in older children the heart rate is >180 BPM [2].

SVT in children is most often caused by an accessory atrioventricular pathway. Children may exhibit a range of clinical findings, from no symptoms to cardiogenic shock, depending on the duration of SVT.


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Literature review current through: Sep 2016. | This topic last updated: Sep 30, 2015.
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