Aetiologic Aspects of Paroxysmal Tachycardia in Infants

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SummaryFamilial Occurrence of PT, and the Physical and Mental Constitution of the ParentsAn attempt has been made to analyze certain aspects of the parents' physical and mental health, by means of a retrospective study.The present series contains only one possible case of familial occurrence of paroxysmal tachycardia (PT).No remarkably high incidence of allergic manifestations, convulsive seizures or migraine is found in the parents. Repeated attacks of syncope in the mothers, as well as peptic ulcer in the fathers, have a numerically higher incidence than that in comparable normal series.The current mental state of the parents, evaluated at follow‐up examination of the infants, showed a somewhat high incidence of neurosis in both mothers and fathers.The nature of a possible relation between the physical illnesses and symptoms in the history of the parents, as well as the incidence of current neuroses, and the early onset of PT in their offspring, respectively, cannot be judged with certainty. An account of them is nevertheless of interest, in view of suggestions by other authors that the constitution of the parents may be of importance in the aetiology of PT in their infants.Factors During Pregnancy and LabourAn analysis has been made of certain factors in the current pregnancy and labour of the mother that might be of aetiologic importance for the occurrence of paroxysmal tachycardia (PT) in the infant.Nothing noteworthy is found with respect to the social status of the mother, evaluated by the occupational status of the parents, nor the incidence of illegitimate births.The incidence of older primiparas is found to be higher than that in a normal series. This difference cannot be explained, but is presumably not to be ascribed to any difficulty in having children (judged by the incidence of previous spontaneous abortions and stillborn children), nor to any remarkably long interval between marriage and birth of the first child.The difference between the age of the parents does not seem to differ from that in a normal population.Pathologic conditions are found to be present at some stage of pregnancy in about 1/5 of the mothers.Instrumental delivery is found to have a relatively high incidence. It is pointed out that, since no definite distinction can be made between cause and effect, it is not justified to draw any conclusions regarding the role of the complicated labour in the occurrence of PT in the infant.The distribution of the birth weight seems to follow a normal distribution in Sweden. The incidence of prematures is not higher than that in a normal population. The birth weight of infants whose PT has an early onset is not found to be remarkably high, as has been claimed earlier. Factors Studied Postnatal!y in the Infant A study of the case records of the 54 infants discloses congenital heart disease in two cases. Both infants had severe cardiac malformations, verified at autopsy. In another case, myocarditis was established by histologic examination.A concurrent infection is recorded in 1/6 of all infants. Vomiting, enlargement of the liver and leukocytosis are more frequent than diarrhoea, fever or a rise in the micro‐sedimentation rate.It is concluded that the contribution of infection to the causation of paroxysmal tachycardia in infants cannot be ruled out. The most common symptoms and signs– which may occur in both infection and cardiac failure–are, however, presumably to be ascribed to the latter.