Internal Medicine

P1: SBT

0521779407-05 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:49

Autosomal Recessive PRD AV Reentrant Tachycardia (AVRT) 209

management

■referral to pediatric nephrologist

■introduce patient and family to Polycystic Kidney Research Founda-

tion (1.800.PKD.CURE)

■genetic counseling for recessive disease

specific therapy

■none available

■management of renal dysfunction

■aggressive blood pressure control

follow-up

■every 6–12 months by pediatric nephrologist

complications and prognosis

■progressive renal failure in most

■with modern management by dialysis, transplantation and liver

replacement if necessary, survival into adulthood is more common

AV Reentrant Tachycardia (AVRT)........................

EDMUND C. KEUNG, MD

history & physical

History

■Re-entrant circuit producing supraventricular tachycardia. Involves

one or more atrioventricular accessory (bypass) tracts or pathways.

■Wolff-Parkinson-White (WPW) or pre-excitation syndrome: ante-

grade conduction over accessory pathway.

■Can have concealed pathways that conduct only from ventricle to

atrium.

■No structural heart disease in most adult patients.

■Long history of intermittent palpitation and tachycardia with abrupt

onset and termination.

Signs & Symptoms

■Abrupt onset and termination of tachycardia. Shortness of breath,

chest discomfort and near- or frank syncope. Rarely, cardiac arrest.

tests

■Basic Tests