Reentrant supraventricular tachycardia in a pediatric trauma patient masquerading as a cardiac contusion

Area of Science:

• Emergency Medicine
• Pediatric Cardiology
• Trauma Surgery

Background:

• Tachycardia diagnosis in trauma patients, especially children, is complex.
• Cardiac contusion is a consideration after trauma but difficult to confirm.
• Atrioventricular nodal reentrant tachycardia (AVNRT) is a common supraventricular tachycardia (SVT) that can be diagnostically challenging.

Purpose of the Study:

• To present a case of pediatric trauma with new-onset AVNRT mimicking cardiac contusion.
• To emphasize the diagnostic challenges in differentiating SVT from cardiac injury in pediatric trauma.
• To highlight the importance of considering arrhythmias in the differential diagnosis of tachycardia post-trauma.

Main Methods:

• Case report of a pediatric trauma patient.
• Review of clinical presentation, electrocardiogram (ECG), and diagnostic workup.
• Discussion of differential diagnoses including cardiac contusion and AVNRT.

Main Results:

• The patient presented with tachycardia following trauma.
• Initial suspicion for cardiac contusion was high due to trauma mechanism.
• The final diagnosis was AVNRT, presenting as a diagnostic challenge and masquerading as cardiac contusion.

Conclusions:

• AVNRT can present as new-onset tachycardia in pediatric trauma patients, mimicking cardiac contusion.
• Careful evaluation of ECG and clinical context is crucial for differentiating SVT from cardiac injury.
• Considering arrhythmias is essential in the management of pediatric trauma patients with unexplained tachycardia.