title: Complications of chest thump for termination of supraventricular tachycardia in children.
abstract: We report on two cases of mechanical termination of supraventricular tachycardia by chest thump which were followed by serious complications. In a 3-year-old boy with an otherwise normal heart, incessant supraventricular tachycardia was converted to sinus rhythm by a single precordial thump. This, however was followed by thrombo-embolic infarction of the left-sided middle cerebral artery. In another case of a 9-year-old girl, recurrent episodes of supraventricular tachycardia were associated with Ebstein anomaly of the tricuspid valve. Chest thump was successful in terminating supraventricular tachycardia but induced a short run of ventricular tachycardia which terminated itself and was then followed by sinus rhythm. It is concluded that even a slight precordial thump implies undetermined risks in the acute management of supraventricular tachycardia in children and should therefore be abandoned in favour of other methods.
authors.affiliation: Department of Paediatric Cardiology, Children's Hospital, University of Giessen, Federal Republic of Germany.
authors.forename: G I
authors.initials: GI
authors.lastname: Müller
authors.forename: H E
authors.initials: HE
authors.lastname: Ulmer
authors.forename: J A
authors.initials: JA
authors.lastname: Bauer
mesh_terms: D002544:Cerebral Infarction / Q000175:diagnosis / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D004569:Electroencephalography; D005260:Female; D006336:Heart Massage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D013615:Tachycardia, Sinoatrial Nodal Reentry / Q000175:diagnosis / Q000628:therapy; D013617:Tachycardia, Supraventricular / Q000175:diagnosis / Q000628:therapy*