Supraventricular tachycardia in pediatric age: a case with Wolff-Parkinson-White syndrome

Supraventricular tachycardia is the most common sustained arrhythmia in childhood. It is characterized by a rapid heart rhythm originating above the ventricles, usually caused by an accessory pathway or a nodal reentry mechanism. In infants, it may present with irritability, poor feeding, or signs of heart failure; in older children, with palpitations or dizziness. We present the case of a 7-year-old girl who attended the emergency department, referred from her health center due to an episode of palpitations. An electrocardiogram was performed, showing findings consistent with supraventricular tachycardia. The patient was hemodynamically stable, and the episode initially resolved with vagal maneuvers. During her stay in the emergency department, she experienced recurrent and persistent supraventricular tachycardia episodes that required intravenous adenosine administration up to 0.2 mg/kg on two occasions. The baseline electrocardiogram obtained after resolution of the tachycardia showed sinus rhythm with signs of ventricular preexcitation (delta wave and short PR interval), findings consistent with Wolff-Parkinson-White syndrome.

Our aim is to highlight the importance of early detection of this condition and, through this clinical case, to focus on the fundamental aspects of its etiology, diagnosis, and therapeutic management.