[Supraventricular tachycardia in a pregnant woman with tertiary malaria; a medical experience from the Indonesian period].

A 22-year-old Indonesian woman became ill with fever and chills in the 7th month of her fourth pregnancy. Two days later she complained of palpitations. At admission again two days later, the temperature was 40 degrees C. The heart rate was 175/min. A blood slide contained trophozoites of Plasmodium vivax. The ECG showed an atrioventricular junctional tachycardia. Treatment consisted of 2 intramuscular injections of 0.5 g quinine hydrochloride administered with an interval of 4 hours. The following morning the temperature was normal and the heart rate had fallen to 100/min. The ECG showed a sinus rhythm. Further therapy consisted of 1.2 g quinine sulphate daily. This case does not support the view that pregnancy may predispose to a paroxysm of tachycardia. It is noteworthy that in this patient 1 gram of quinine hydrochloride not only controlled a malaria attack but also terminated a paroxysm of tachycardia.