Diagnosis: The 12-lead electrocardiogram shown on the previous screen is consistent with supraventricular tachycardia (SVT).
The patient became quite anxious during this episode. A bag of ice was applied over his face for 20 seconds, but vagal maneuvers failed to convert his tachycardia to normal sinus rhythm.
A rapid intravenous push of adenosine (0.1 mg/kg) converted the SVT to normal sinus rhythm, as seen in this image.
Though rare, SVT can occur after nebulized albuterol administration, especially in the presence of heart disease. In addition, SVT is the most common symptomatic arrhythmia in children.
Predisposing factors for SVT include congenital heart disease, fever, and sympathomimetics; this patient had all of these.
Case presented by Muhammad Waseem, MD, Padma Gadde, MD, and Gerard Devas, MD.
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