Abdominal Pain as an Initial Manifestation of Paroxysmal Supraventricular Tachycardia in Children

The aim of this study was to evaluate the importance of abdominal pain in children with paroxysmal supraventricular tachycardia (PSVT). The authors reviewed the medical records of patients aged between three and 18 years old, who were diagnosed and treated for PSVT between March, 2011 and February, 2016. According to the presence of abdominal pain, they were grouped and analyzed for the difference of patient’s age, gender, interval between symptom onset and diagnosis, response to adenosine infusion, and the relationship with levels of N-terminal fragments of pro-brain natriuretic peptide (NT-proBNP). A total of 43 patients (24 males and 19 females) were registered and the mean age at diagnosis of PSVT was 10.65 ± 4.81 years old. Although palpitation was the most common symptom (n = 29, 67.4 %), abdominal pain was also common (n = 18, 41.9%) with more frequent symptoms under 10 years old (n = 15/16, 93.8% versus n = 3/27, 11.1% in older than 10 years old). The PSVT patients with abdominal pain (group 1) were younger, had more frequent vomiting, less palpitation, and longer time to diagnosis of PSVT than subjects without this complication (group 2). In group 1, the level of NT-proBNP was shown significantly higher than group 2 (776.07 ± 913.57 versus 93.72 ± 51.25 pg/mL, P < 0.001). Abdominal pain may be an initial presentation of PSVT in children, especially under 10 years old.