Differential Diagnosis for Skipped Beats in Preterm Neonate
- Single Most Likely Diagnosis
- Premature atrial contractions (PACs): This is the most common cause of skipped beats in preterm neonates, often benign and resolving on their own. They are usually isolated and not associated with any underlying cardiac disease.
- Other Likely Diagnoses
- Premature ventricular contractions (PVCs): Similar to PACs, PVCs are common in neonates and can cause skipped beats. They are often benign but can be associated with underlying cardiac conditions or electrolyte imbalances.
- Sinus arrhythmia: A normal variation in heart rate that can be more pronounced in neonates, leading to the perception of skipped beats.
- Atrial flutter or supraventricular tachycardia (SVT): Although less common, these arrhythmias can occur in neonates and cause skipped beats or palpitations.
- Do Not Miss Diagnoses
- Congenital heart block: Although rare, this condition can cause significant morbidity and mortality if not promptly diagnosed and treated. It is often associated with maternal autoimmune diseases.
- Long QT syndrome: A condition that can lead to life-threatening arrhythmias, including torsades de pointes. It may present with skipped beats or palpitations.
- Cardiac structural anomalies: Certain congenital heart defects can cause arrhythmias, including skipped beats. Early diagnosis is crucial for appropriate management.
- Rare Diagnoses
- Wolff-Parkinson-White (WPW) syndrome: A rare condition in neonates characterized by an accessory electrical pathway in the heart, leading to arrhythmias.
- Ventricular tachycardia: A life-threatening arrhythmia that is rare in neonates but requires immediate attention.
- Cardiomyopathy: Although rare in neonates, cardiomyopathy can cause arrhythmias, including skipped beats, and requires prompt diagnosis and treatment.