Newborn in cardiogenic shock

Abstract

Clinical introductionA 2-month-old baby boy was referred to our centre due to tachycardia and acute heart failure. The ECG showed a narrow complex tachycardia with a heart rate of 300 beats per minute (Figure 1). Echocardiographically, a patent foramen ovale and a parachute mitral valve with mild regurgitation were diagnosed; cardiac function was highly impaired.Figure 1ECG (50 mm/s) showing the small complex tachycardia.QuestionWhich of the following is the most likely diagnosis?Ectopic atrial tachycardiaAtrial flutterChaotic atrial tachycardiaFocal micro re-entrant tachycardiaAtrial fibrillation