Excessive cry in small babies must not be ignored, it can be arrhythmia: AIIMS Bhubaneswar Expert

Bhubaneswar: If your baby is crying excessively for hours then it should not be ignored. Most of us take it lightly and think of it as colic or something else. But it can be arrhythmia, which can be dangerous for babies. So, stethoscope should be put on baby and heart rate should be examined as well, said Dr. Pankaj Mohanty, Associate Professor of Neonatology Department, AIIMS Bhubaneswar. Dr. Mohanty said this in the context of an emergency kind of situation that happened and still going at AIIMS Bhubaneswar.

A 25 days old baby girl came to AIIMS Bhubaneswar on Tuesday night with excessive crying. The baby girl was crying consistently for more than 12 hours. Baby was crying intermittently and was not taking feed. Prior coming to AIIMS Bhubaneswar the case of the baby was treated as abdominal colic, otitis or sepsis. At AIIMS, a team of doctors led by Dr. Mohanty checked vitals of the baby. Heart Rate (HR) of the baby was found to be 300bpm(normal HR should be within 140). Then the baby girl underwent immediate ECG. It revealed an absent p wave and HR 288, s/ O PSVT. Baby was taken to the NICU. The baby girl was provided two doses of I.v adenosine in proper technique but failed to revert the rhythm. Then amiodarone infusion started which resulted HR coming down to 270 but still psvt was there in continuous ecg. Then Doctors had to give Shock 2 j/ kg. It resulted well and rhythm reverted to normal and persisted. Baby went into shock, intubated, required noradrenaline and milrinone(myocardial contractility). Baby was managed for 24 hrs and the rhythm was normal. Baby was extubated to room air, infusions stopped and the baby doing well on oral propranolol and taking breast feeding well, informed Dr. Mohanty. 

Dr. Ramachandra Barik, Additional Professor, Cardiology Department of AIIMS Bhubaneswar helped in Echocardiography and helped in managing the baby. Similarly, Dr. Purbasha, DM Resident in the team first saw the baby girl and alerted the system. Dr. Hemant, Junior Resident Pediatrics Department including others were the part of the team.

This type of case happens quite often. But parents as well as treating Doctors should be aware about this. Every child crying excessively is not a case of colic, otitis or sepsis. It can be arrhythmia, which can be fatal if not diagnosed in time, said Dr. Mohanty. The baby girl who came to AIIMS Bhubaneswar is now doing well and it has been planned to do electrophysiology study and if required radio frequency ablation will also be done, said Dr. Mohanty. Entire team treating the baby girl is now happy for her recovery as all faculties of the Department and many residents have tested COVID positive. Only Dr. Mohanty is not affected. But, Dr. Mohanty with his team managed to do the job excellently.