PMC5412654_01
A: Electrocardiogram demonstrating supraventricular tachycardia at a rate of 234 beats per minute. There are retrograde P waves consistent with atrioventricular re-entrant tachycardia. B: A 12-lead electrocardiogram in sinus rhythm at a rate of 120 beats per minute with no evidence of pre-excitation.
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At presentation, tachycardia was noted and a 12-lead electrocardiogram confirmed SVT at a rate of 240 beats per minute (Figure 1). There was no pre-excitation on the 12-lead electrocardiogram (Figure 1).
A: Apical 4-chamber view showing main thrombus arising from the left atrial appendage and isolated thrombus attached at the roof of the right atrium. B: Apical 4-chamber view showing small thrombus adjacent to the right pulmonary veins in the left atrium. C: Parasternal short-axis view showing main thrombus at the base of the left atrial appendage and separate thrombus deep in the left atrial appendage.
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A complete echocardiogram to reassess ventricular function and exclude structural heart disease was performed on day 3 of admission in the pediatric intensive care unit and revealed mobile hyperechoic masses in the right and left atria consistent with multiple thrombi (Figure 2).