Effect of Hydralazine in Hypertension

AURICULAR PAROXYSMAL TACHYCARDIA BRrr 27 of treatment and then suddenly the rate was reduced.Pneumonia as an associated disease was present in Cases 3 and 4.Only two drugs were used to reduce the heart rate-neo- stigmine and digitalis, the latter as tincture or digoxin.Neostigmine was effective in Case 1.The dose given was 0.125 mg. by intramuscular injection to an infant of 4 weeks.In the other five cases digox.inor tincture of digi- talis by mouth was effective.Digoxin orally seemed to be the drug of choice.A suitable dose was 0.125 mg.repeated two or three times daily until the heart slowed.Even the smallest babies tolerated such a dose, and indeed it seemed necessary to control the rapid heart action. SummaryAuricular paroxysmal tachycardia is less rare than is often supposed.In the cases seen in hospital the so-called " paroxysm" usually lasted several days.The common clinical picture in childhood is that of cardiac failure associated with an extremely rapid heart rate (200-350 beats a minute).The insidious onset of such failure is frequently missed in children unless looked for.Pneumonia may be the assumed diagnosis, and indeed is often present in addition to the tachycardia.Both conditions demand treatment.The incidence of congenital heart disease in associa- tion with auricular paroxysmal tachycardia seems to be quite low.Digitalis would appear to be the drug of choice in treatment.Large doses are tolerated in infancy and seem necessary for recovery.A smaller maintenance dose for four to eight weeks should be given to prevent early recurrence of the tachycardia.I wish to thank Dr.