Atypical Presentation of Right Ventricular Outflow Tract Ventricular Tachycardia

Jeffrey M Landreville; Gary I Joubert; Eva Welisch; Krista Helleman; Naveen P Poonai

doi:10.1016/j.jemermed.2014.06.033

Atypical Presentation of Right Ventricular Outflow Tract Ventricular Tachycardia

J Emerg Med. 2015 Oct;49(4):432-5. doi: 10.1016/j.jemermed.2014.06.033. Epub 2015 Jul 17.

Authors

Jeffrey M Landreville¹, Gary I Joubert², Eva Welisch³, Krista Helleman², Naveen P Poonai²

Affiliations

¹ Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
² Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Pediatrics, Western University, London, Ontario, Canada; Division of Emergency Medicine, Western University, London, Ontario, Canada.
³ Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Pediatrics, Western University, London, Ontario, Canada.

PMID: 26194529
DOI: 10.1016/j.jemermed.2014.06.033

Abstract

Background: Ventricular tachycardia (VT) in the pediatric population is rare, has a wide differential diagnosis, and can present in numerous ways. In the absence of underlying heart disease, VT is considered idiopathic and is associated with an excellent prognosis. Right ventricular outflow tract ventricular tachycardia (RVOT-VT) represents the most common form of idiopathic VT. The differential diagnosis, mechanism, presentation, management, and prognosis of RVOT-VT in the pediatric population will be discussed.

Case report: We report a case of RVOT-VT that was incidentally discovered in an 11-year-old girl during an emergency department workup for severe headache. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: It is essential for emergency physicians to have an approach to pediatric VT and appreciate the wide range of potential presentations. Differentiating idiopathic VT, such as RVOT-VT, from more malignant forms of VT can be challenging and requires expert consultation for further diagnostic workup and management.

Keywords: headache; idiopathic; pediatrics; right ventricular outflow tract; ventricular tachycardia.

Publication types

Case Reports

MeSH terms

Child
Diagnosis, Differential
Electrocardiography
Female
Headache Disorders / diagnosis
Humans
Incidental Findings
Tachycardia, Ventricular / diagnosis*
Ventricular Outflow Obstruction / complications
Ventricular Outflow Obstruction / diagnosis*