When Fussiness Is Not Just Fussiness: A Case Report of Early Wolff-Parkinson-White Syndrome Recognized in Primary Care.

This case report describes a two-week-old term infant who initially presented with nonspecific symptoms of vomiting and diarrhea in the outpatient setting. Despite an unremarkable birth history, the patient's clinical condition deteriorated, and subsequent evaluation in the emergency department revealed supraventricular tachycardia (SVT), necessitating multiple drug and direct-current cardioversion attempts. The infant was promptly transferred to a tertiary care center with a pediatric intensive care unit, cardiology, and electrophysiology. Initial electrocardiogram showed a wide complex tachycardia concerning for SVT, later revealing Wolff-Parkinson-White syndrome, and started on antiarrhythmic therapy. This report highlights the critical role of primary care providers in recognizing and managing early-onset SVT to prevent acute heart failure and other morbidity and mortality.